A Case of Type 1 Diabetes Mellitus With Intractable Chronic Diarrhea and Challenging Glycemic Control.

The first step in treating diabetes mellitus (DM)-related diarrhea is to thoroughly control the serum glucose level. The authors herein describe a 75-year-old man who was diagnosed with type 1 DM when he was 32 years old. The patient lost his appetite due to hot weather and spent a week eating sweets and drinking juice.

A case of multiple cerebral hemorrhages followed by shower emboli.

An 87-year-old woman was admitted to our hospital (day 0) because of acute disorientation caused by multiple acute intracerebral hemorrhages. T2*-weighted magnetic resonance imaging (MRI) at admission revealed multiple subcortical old microbleeds indicative of cerebral amyloid angiopathy. Microbleeds in the right cerebellar hemisphere and acute spotty ischemia in the left cerebellum were also identified.

Watershed cerebral infarction in a patient with a persistent primitive trigeminal artery and contralateral internal carotid artery stenosis: A case report.

Patients with a persistent primitive trigeminal artery frequently have a poorly developed vertebrobasilar arterial system. However, they are not at higher risk of stroke and most are asymptomatic. Left cerebral watershed infarction was identified in a 75-year-old man who presented with aphasia and disorientation on magnetic resonance image (MRI).

Zn-Based Metal-Organic Frameworks Using Triptycene Hexacarboxylate Ligands: Synthesis, Structure, and Gas-Sorption Properties.

Invited for the cover of this issue is the group of Koh Sugamata, Mao Minoura, and co-workers at Rikkyo University. The image depicts triptycene-based metal-organic frameworks with honeycomb structures that collect carbon dioxide and hydrogen, in an analogy to bees collecting honey in their honeycombs. Read the full text of the article at 10.

Midline Shift Induced by the Drainage of Cerebrospinal Fluid in Three Patients With External Decompression.

It is not rare that progressive hydrocephalus worsens clinical conditions in a patient with external decompression and drainage or shunt surgery is required. However, spinal drainage or shunt surgeries potentially carry a risk of causing paradoxical herniation in a patient with decompressive craniectomy, particularly in a comatose case with wide craniectomy. Careful and strict observations are necessary for such patients.

Zn-Based Metal-Organic Frameworks Using Triptycene Hexacarboxylate Ligands: Synthesis, Structure, and Gas-Sorption Properties.

A series of metal-organic frameworks (MOFs) based on zinc ions and two triptycene ligands of different size have been synthesized under solvothermal conditions. Structural analyses revealed that they are isostructural 3D-network MOFs. The high porosity and thermal stability of these MOFs can be attributed to the highly rigid triptycene-based ligands.

Primary central nervous system lymphoma (PCNSL) mimicking a falx meningioma with increasingly massive intracerebral hemorrhage.

When using imaging to diagnose brain tumors, it is important to determine whether the tumor is intra- or extra-parenchymal. An 80-year-old man was found on magnetic resonance imaging to have an enhanced mass that appeared to be in the falx and a massive hematoma in the left frontal lobe; the provisional diagnosis was falx meningioma. However, the tumor and hematoma were found intraoperatively to be completely intraparenchymal.

Fulminant infectious endocarditis caused by with pseudoaneurysms in the superior mesenteric, hepatic, and popliteal arteries: a case report.

infectious endocarditis has a high mortality, major causes of death being cardiac failure, systemic embolism, and sepsis. Pseudoaneurysms, a rare complication of this infection, are not invariably fatal with appropriate treatment. A previously healthy 32-year-old man was found to have multiple cerebral infarctions, and infectious endocarditis with mitral valve vegetation was diagnosed by echocardiography.

A Case of Lymphomatosis Cerebri Presenting with Rapid Progression of Dementia: A Literature Review.

Lymphomatosis cerebri is an atypical form of primary central nervous system lymphoma (PCNSL), which frequently causes rapid progression of dementia. A 68-year-old woman exhibited rapidly progressing disorientation and a mini-mental state examination score of 9. The fluid-attenuated inversion recovery of a magnetic resonance image (MRI) demonstrated focal areas of high-signal intensity in the right frontal lobe with a small enhancement, which was histologically diagnosed as diffuse large B-cell type lymphoma.

A Pilot Study on Pain Assessment Using the Japanese Version of the Critical-Care Pain Observation Tool.

Background: Critically ill patients experience various types of pain that are difficult to assess because patients cannot communicate verbally due to artificial airways and sustained sedation. The Critical-Care Pain Observation Tool (CPOT) objectively evaluates patients' pain.

Aims: This study aimed to re-assess the reliability and validity of the Japanese version (CPOT-J) and to reveal limitations of behaviors specific to mechanically ventilated patients.

Cerebellar high-grade glioma with H3 K27M mutation: illustrative case.

Background: Diffuse midline glioma H3 K27M-mutant is a distinct subtype of glial tumors newly introduced in the revised fourth edition of the World Health Organization . They are aggressive pediatric tumors with a poor prognosis but have also been reported in adults.

Observations: The authors present the case of a man in his 60s who presented with rotatory vertigo, taste disorder, and right facial paralysis.

Lacunar Infarction Caused by Chronic Subdural Hematoma.

In chronic subdural hematoma (CSDH) patients, motor functions usually recover quickly after burr-hole surgery; however, in a rare case, the hemiparesis showed poor improvement after surgery. In that case, investigation of cerebral infarctions is important. Among the 284 CSDH patients with motor weakness, magnetic resonance image (MRI) and MR angiography (MRA) were acquired in 82 patients before surgery when the hemiparesis progressed rapidly.

New Injection Points of Onabotulinum Toxin A for Spastic Paralysis of the Fingers: Eight Cases of Report.

Objective: Onabotulinum toxin A (botulinum A toxin) is utilized to extend flexed extremities in spastic hemiparesis. Injection points are important to obtain a better effect. Injecting botulinum A toxin into the forearm muscles is a standard method for flexed wrist and fingers; however, we developed new injection points in the intrinsic muscles of the hand to acquire more reliable effect.

Features of psychological reactions induced by perampanel: A case report.

What Is Known And Objective: Perampanel, an anticonvulsant, might induce psychological reactions.

Case Description: A 70-year-old woman, who had been taking 2500 mg/day levetiracetam, complained of right-hand minor-convulsion. Perampanel of 2 mg/day was additionally prescribed, and the dosage was increased to 4 mg/day.

Pinwheel-Shaped Titanium Plates Should Be Fixed to the Skull Using All Screw Holes to Protect the Plates from Being Bent.

Introduction: In cranioplasty, pinwheel-shaped titanium mini plates are frequently used to cover bone defects produced by burr holes, and it is common to insert screws through only a few of the holes in cranial flap fixation.

Presentation Of Case: A 69-year-old man who had undergone clipping surgery for subarachnoid hemorrhage 16 years previously visited our clinic because a titanium plate had penetrated his scalp one month after he was hit on the head by a wall cabinet. Imaging studies revealed that part of the titanium plate had bent outwards and penetrated the skin.

Subdural Tension on the Brain in Patients with Chronic Subdural Hematoma Is Related to Hemiparesis but Not to Headache or Recurrence.

Background: Hemiparesis is a major symptom of chronic subdural hematoma (CSDH). Its severity does not always correlate with hematoma size. The authors analyzed hematoma thickness, pressure, and tension to clarify the mechanism of hemiparesis in CSDH patients.

Supraglottic airway device versus a channeled or non-channeled blade-type videolaryngoscope for accidental extubation in the prone position: A randomized crossover manikin study.

Background: It is very rare but challenging to perform emergency airway management for accidental extubation in a patient whose head and neck are fixed in the prone position when urgently turning the patient to the supine position would be unsafe. The authors hypothesized that tracheal intubation with a videolaryngoscope would allow effective airway rescue in this situation compared with a supraglottic airway device and designed a randomized crossover manikin study to test this hypothesis.

Methods: The authors compared airway rescue performances of the 3 devices-the ProSeal laryngeal mask airway (PLMA; Teleflex Medical, Westmeath, Ireland) as a reference; the Pentax AWS (AWS; Nihon Kohden, Tokyo, Japan) as a channeled blade-type videolaryngoscope; and the McGRATH videolaryngoscope (McGRATH; Medtronic, Minneapolis, MN) as a nonchanneled blade type in a manikin fixed to the operating table in the prone position.

Primary spinal cord astroblastoma: case report.

Astroblastoma is a rare tumor that is thought to occur exclusively in the cerebrum. To the authors' knowledge, no cases of spinal cord astroblastoma have been reported. A 20-year-old woman presented with numbness in her legs.

Headache in patients with chronic subdural hematoma: analysis in 1080 patients.

Headache is a major symptom in chronic subdural hematoma (CSDH) patients. However, some CSDH patients do not complain headache although the hematoma is thick with definite midline shift. This clinical study was performed to identify the mechanism of headache in CSDH patients.

A Case of Breast Cancer Brain Metastasis with a 16-Year Time Interval without Evidence of Cancer Recurrence.

The median time of brain metastasis from the diagnosis of breast cancer is approximately 3 years. In this case report, a 69-year-old woman demonstrated cerebellar ataxia. Brain magnetic resonance imaging revealed enhanced lesions in bilateral cerebellar hemispheres.