Implementation of a telestroke system for general physicians without a nearby stroke center to shorten the time to intravenous thrombolysis for acute cerebral infarction.

Aim: We aimed to establish a telestroke system for general physicians in areas without a nearby stroke center and investigate its usefulness for recombinant tissue plasminogen activator (rt-PA) therapy for patients with acute cerebral infarction.

Methods: We used a hub and spoke model, in which a hub hospital provided telestroke support to the spoke hospitals in rural areas that were not nearby a stroke center. The telestroke support device enabled the sharing of images and real-time face-to-face discussion with a stroke specialist for diagnosis and treatment.

Intra-abdominal mucinous adenocarcinoma of urachal origin: report of a case.

Intra-abdominal mucinous cystic tumors can be difficult to diagnose preoperatively. We report a case of histologically diagnosed primary urachal adenocarcinoma: a rare type of bladder tumor. This case report is interesting for clinicians.

[A case of colon cancer with multiple lung metastases responding completely to FOLFIRI and FOLFOX therapy].

A 74-year-old man was administered FOLFIRI therapy, followed by modified FOLFOX therapy and FOLFIRI therapy due to ascending colon carcinoma with multiple lung metastases. After 19 months, the tumor marker became normal, and CT and PET-CT revealed the multiple lung metastases had disappeared. He was operated due to stenosis of the ascending colon carcinoma, and is now being treated with chemotherapy due to liver metastasis.

[A case of locally advanced rectal cancer responding to FOLFOX].

The 57-year-old man was underwent sigmoid colostomy due to unresectable rectal carcinoma. Then he was treated with chemotherapy of levofolinate/5-fluorouracil/oxaliplatin(FOLFOX). After completion of 12 courses of chemotherapy, MR revealed responses.

Acute adrenal hemorrhage after blunt trauma.

Objective: To determine the appropriate management of adrenal hemorrhage in patients with severe chest and upper abdominal blunt trauma.

Materials And Methods: We reviewed 7 patients who suffered from severe traumatic adrenal hemorrhage after a traffic accident (n = 4) or fall (n = 3). Contrast-enhanced CT images were analyzed for multi-organ traumatic injury, hematoma size, extravasation, and pseudoaneurysm formation.

Hemorrhage into pancreatic pseudocyst.

We report a patient whose upper abdominal pain was due to an alcoholic pancreatic pseudocyst with hemorrhage. CT showed a gradually enhancing pancreatic pseudocyst about 6 cm in diameter. It exhibited hyposignal intensity on T2-weighted images and hypersignal intensity on T1-weighted images.

[A case of recurrent breast cancer with bone metastasis causing pancytopenia--efficacy of low-dose CPT-11+ MPA].

A 46-year-old woman underwent breast-conserving surgery. The patient was treated with six cycles of CMF and, subsequently, combination therapy with UFT and CPA. However, multiple metastases were detected in the thoracic vertebrae after two years and two months of surgery.

[A case with advanced carcinoma of the gallbladder responding to UFT monotherapy].

Gallbladder carcinoma is a fatal disease with highly metastatic potential, and the chemotherapeutic regimen has not been established yet. We reported here a case of gallbladder carcinoma with lung and liver meatstases responding to a single agent, UFT. A 70-year-old female with advanced carcinoma of the gallbladder and bilateral pulmonary metastases were treated with UFT 600 mg/day weekday for half a year.