Measurement of shift of the cauda equina in the subarachnoid space by changing position.

Background And Objectives: To perform spinal anesthesia, patients are usually placed in the lateral decubitus position with the knees drawn up to the stomach, the legs fully flexed, and the neck flexed to curve the back outward. Because the nerve roots of the cauda equina have considerable mobility in the subarachnoid space, the position of the cauda equina in the lateral decubitus position may be different from that in the supine position. However, the anatomic position of the cauda equina in the lateral decubitus position with fully flexed legs has not been carefully studied.

Erythropoietin strongly protects the liver from ischemia-reperfusion injury in a pig model.

Background/aims: We investigated, for the first time, the protective effect of erythropoietin (EPO) against liver ischemia-reperfusion (I-R) injury in a pig model.

Methodology: Partial hepatic ischemia was maintained for 60 min in a pig. Pigs were allocated to 4 groups (n=5 each): (1) Control group with I-R injury (Vehicle); (2) EPO group with I-R injury, given three injections of EPO at 5000 IU/kg (EPO5000x3); (3) EPO group with I-R injury, given a single injection of EPO at 5000 IU/kg (EPO5000x1); and (4) EPO group with I-R injury, given three injections of EPO at 500 IU/kg (EPO500x3).

Nodular lymphoid hyperplasia: rare case of lymphoproliferative disease in the lung.

We report a rare case of nodular lymphoid hyperplasia in the lung. An 18-year-old woman had an abnormal shadow found on chest radiography images. Positron-emission tomography showed an uptake of (18)F-fluorodeoxyglucose in the mass lesion, with a maximum standardized uptake value of 2.

A case of eosinophilic pneumonia successfully treated with suplatast tosilate alone.

We report a case of eosinophilic pneumonia that was successfully treated with suplatast tosilate. A 72-year-old woman with hypertension and diabetes, who did not smoke and did not have pets, consulted a physician with the chief complaints of cough, sputum, and slight fever. Chest X-ray films revealed a permeation shadow in the bilateral upper lobes.

Histological variety of localized lymphoid hyperplasia of the large intestine: histopathological, immunohistochemical and genotypic findings of 16 cases.

Previous reports emphasized that localized lymphoid hyperplasia (LLH) of the large intestine is usually histologically characterized by large lymphoid follicles with striking enlarged germinal centers, and a narrow surrounding mantle zone and marginal zone (MZ). To clarify the histological varieties of LLH of the large intestine, 16 such cases have been studied. The present study demonstrated histological diversity of the LLH of the large intestine including (i) reactive follicular hyperplasia (RFH) (n=8), (ii) RFH with progressive transformation of the germinal center (PTGC) (n=3), (iii) RFH with MZ hyperplasia (n=3) and (iv) RFH with PTGC and MZ hyperplasia (n=2).

Rapamycin inhibits growth of cholangiocarcinoma cells.

Background/aims: The immunosuppressive agent rapamycin is currently being evaluated for its antineoplastic effect. In the present study, the antineoplastic effect of rapamycin against cholangiocarcinoma was studied in vitro.

Methodology: To explore the therapeutic potential of rapamycin, expression of mTOR in four cholangiocarcinoma cell lines--TFK1, HuCCT1, NOZW, and OZ--was evaluated by real-time PCR.

Inflammatory pseudotumor of the thyroid gland showing prominent fibrohistiocytic proliferation. A case report.

Inflammatory pseudotumor of the thyroid gland (IPT) appears to be exceedingly rare. Histologically, 14 previously reported cases demonstrated plasma cell granuloma variant. We report here an IPT showing a predominantly fibrohistiocytic proliferation that occurred in a 75-year-old Japanese woman.

An experimental model of encapsulating peritoneal sclerosis.

In Japan, only about 3% of all patients with end-stage renal disease are maintained by continuous ambulatory peritoneal dialysis (CAPD). Although the reasons for the low proportion of patients receiving CAPD are multifactorial, encapsulating peritoneal sclerosis (EPS), a fatal complication of CAPD, is a major factor. In 1995 we developed a rat model of EPS, and in 2001 also developed an EPS model in mice.

Performance of integrated FDG PET/contrast-enhanced CT in the diagnosis of recurrent colorectal cancer: Comparison with integrated FDG PET/non-contrast-enhanced CT and enhanced CT.

Purpose: The aim of our study was to evaluate the accuracy of integrated positron emission tomography and computed tomography (PET/CT) using (18)F-fluorodeoxyglucose (FDG) with IV contrast for depiction of suspected recurrent colorectal cancer and to assess the impact of PET/contrast-enhanced CT findings on clinical management compared with PET/non-contrast-enhanced CT and CT component.

Methods: One hundred seventy patients previously treated for colorectal cancer underwent PET/CT consisting of non-enhanced and contrast-enhanced CT for suspected recurrence. PET/contrast-enhanced CT, PET/non-contrast-enhanced CT and enhanced CT were interpreted by two experienced radiologists by consensus for each investigation.

[Case of undiagnosed vasospastic angina first noted during anesthesia].

A 75-year-old man patient was scheduled for total gastrectomy, splenectomy, and cholecyctectomy who had been hypertensive. The patient had no symptoms related to cardiac disease before surgery. Preoperative ECG showed only complete right bundle branch block.

Expression profile of REG family proteins REG Ialpha and REG IV in advanced gastric cancer: comparison with mucin phenotype and prognostic markers.

Regenerating gene family members 1 (REG Ialpha) and 4 (REG IV) are overexpressed in a subset of gastric cancers. However, comparative characterization of the expression of these family proteins has remained unclear. Therefore, we aimed to elucidate not only the association between REG protein expression and mucin phenotype but also their significance as a prognostic marker for patients with gastric cancer.

[Effects of topical Dry Nose Spray on the transepithelial water loss and potential difference in human nasal mucosa].

Background: Nasal airway is the entrance to the respiratory tract. The upper airway has function of humidification and secretion. We have already demonstrated the human nasal mucosal water loss as the transepithelial water loss.

[Posttraumatic pseudomeningocele--a case report].

Pseudomeningocele is a rare complication of head trauma. An 7-year-old male child who fell from playground equipment was admitted to hospital with lambdoid sutural diastatic fracture. As epidural and subgaleal fluid collections gradually developed from the subsequent day of admission, a subgaleal drain was placed for cerebrospinal fluid (CSF) diversion.

Outcome of surgical resection for hilar cholangiocarcinoma in elderly patients.

Background/aims: The aim of the present study was to assess the safety and outcome of surgical resection for hilar cholangiocarcinoma in the elderly.

Methodology: Thirty-one patients with hilar cholangiocarcinoma were divided into two groups: Group 1 (n=8), less than 65, and; Group 2 (n=23), 65 years of age and older. Patient characteristics, peri-operative data, 5-year survival rates and 5-year disease-free survival rates were compared between the two groups.

Early intervention with suplatast tosilate for prophylaxis of pediatric atopic asthma: a pilot study.

The onset of asthma may be related to Th2 cytokine dominance at the time when food allergies occur several months after birth. This study investigated the effectiveness of early intervention with a Th2 cytokine inhibitor (suplatast tosilate) for prevention of asthma in infants with food allergies and atopic dermatitis. Suplatast tosilate dry syrup (6 mg/kg daily) or a histamine H(1)-blocker (ketotifen fumarate dry syrup: 0.

Accuracy of integrated FDG-PET/contrast-enhanced CT in detecting pelvic and paraaortic lymph node metastasis in patients with uterine cancer.

The purpose is to evaluate the accuracy of integrated (18)F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography ((CT) with intravenous contrast medium in detecting pelvic and paraaortic lymph node metastasis in patients with uterine cancer, with surgical and histopathological findings used as the reference standard. Forty-five patients with endometrial or uterine cervical cancer underwent radical hysterectomy, including pelvic lymphadenectomy with or without paraaortic lymphadenectomy, after PET/CT. PET/CT findings were interpreted by two experienced radiologists in consensus.

[Study of personal best value of peak expiratory flow in patients with asthma--comparison of the highest value of daily PEF under good control and the highest value of daily PEF obtained after using repeated inhaled beta2-agonist during high-dose inhaled steroid treatment].

Background: In the guideline for asthma management, it is important to find the personal best value of peak expiratory flow (best PEF). Recently, we have substituted the highest value of PEF in daily life under good control (daily highest PEF) for the best PEF.

Aim: In the present study, we considered whether the daily highest PEF could be used as the best PEF or not.

[Various clinical symptoms in human parvovirus B19 infection].

Human parvovirus B19 infection causes erythema infectiosum in child, aplastic crisis in patients with chronic hemolytic anemia, chronic pure red cell aplasia in immunocompromised patients and hydrops fetalis. Human parvovirus B19 causes arthritis and acute glomerulonephritis due to immunological mechanism. Other disorders, rheumatoid arthritis, vasculitis and thrombotic microangiopathy, are linked in human parvovirus B19 infection.

Serum alpha-fetoprotein level per tumor volume reflects prognosis in patients with hepatocellular carcinoma after curative hepatectomy.

Background/aims: The clinical usefulness of alpha-fetoprotein (AFP) in the management of hepatocellular carcinoma (HCC) remains controversial. This study aimed to assess the prognostic reliability of serum AFP levels per tumor volume (AFP/volume) after curative resection.

Methodology: A total of 196 patients with HCC were analyzed with reference to serum AFP levels at diagnosis.

Life-threatening bleeding from duodenal varices due to pancreatic arterio-venous malformation: role of emergency pancreatoduodenectomy.

Life-threatening gastrointestinal bleeding due to arterio-venous malformation around the pancreatic head is a rare clinical entity. Herein we report a 60-year-old male patient with uncontrolled bleeding from varices of the duodenum due to pancreatic arterio-venous malformation, who was treated by emergency surgery. Upper GI endoscopy revealed bleeding from juxta-ampullary duodenal varices.

[A case of laryngeal sarcoidosis difficult to diagnose].

Sarcoidosis is a multiorgan granulomatous disease of unknown cause, named after the characteristic histopathological findings of the disease. In this article, we shall report a case in which biopsy needed to be repeated three times until a final diagnosis of laryngeal sarcoidosis could be made. Since sarcoidosis associated with only a laryngeal pathology may not be associated with any laboratory abnormalities in many cases, first priority should be attached in suspected cases to detect the presence of noncaseating epithelioid cell granulomas.

Involvement of REG Ialpha protein in the regeneration of ductal epithelial cells in the minor salivary glands of patients with Sjögren's syndrome.

The regenerating gene (Reg) was originally isolated from regenerating rat pancreatic islets and revealed recently to constitute a multi-gene family in humans. REG Ialpha protein is known to be overexpressed not only in various human inflammatory diseases but also in various experimental models of inflammation in animal tissues. However, its involvement in pathophysiology of the minor salivary gland (MSG) is not clear.

Role of Necl-5 in the pathophysiology of colorectal lesions induced by dimethylhydrazine and/or dextran sodium sulphate.

Necl-5 is an immunoglobulin-like molecule that was originally identified as a poliovirus receptor. Although Necl-5 expression is often up-regulated in cancer cells, its pathophysiological significance in the development of cancer remains unclear. We investigated the roles of Necl-5 in the development of colitis-associated neoplasia.