Resected osteochondroma of the rib in an elderly patient.

Solitary osteochondroma of the rib is a rare primary chest wall tumor. Herein, we report a case of a successfully resected osteochondroma of the rib. The patient was a 73-year-old asymptomatic woman who came to our hospital regularly for treatment of hypertension and hyperlipidemia.

[Combined effect of cyclosporin and prednisolone for minimal change nephrotic syndrome: comparison with prednisolone therapy].

Background: Minimal change nephrotic syndrome (MCNS) is the most common type of glomerular disease and treated mainly with corticosteroids, usually prednisolone(PSL). The recurrence rate during PSL treatment is approximately 20-30 %. In addition, the adverse effects of long term PSL treatment include diabetes, osteoporosis, infection etc, most of which are serious.

Modified hemi-double-stapling technique combined with the temporal abdominal-wall-lift method for performing Billroth I anastomosis after laparoscopically assisted distal gastrectomy.

The authors have used a modified hemi-double-stapling (HDS) technique for reconstruction after laparoscopically assisted distal gastrectomy. The stomach is resected from the greater curvature side using a linear stapler inserted into the stomach from that side at a position vertical to the line of the greater curvature. Resection of the stomach is performed by extending the resection line to the lesser curvature using laparoscopic coagulating shears.

A case of Hirayama disease.

We report a male patient with Hirayama disease aged 13. The disease was insidiously progressive and he had severe disability of the right hand at presentation. He had muscular atrophy in the intrinsic muscles of the right hand and in the distal muscles of the right forearm.

Primary localized cutaneous amyloidosis with unusual clinical features in a patient with Sjögren's syndrome.

A 69-year-old woman presented with a 2-year history of an eczematous lesion covering the genital area. Histopathological examination showed deposits of amorphous, eosinophilic material and an infiltrate of plasma cells through the entire dermis into the subcutaneous fatty tissue. Congo red-stained deposits showed apple-green birefringence with polarizing microscopy.

Dose effects of cross-linking polyethylene for total knee arthroplasty on wear performance and mechanical properties.

Wear performance and mechanical properties of cross-linking polyethylene (XLPE) tibial inserts were investigated using a knee simulator, scanning electron microscopy (SEM), and a small punch test (SPT). Ultrahigh molecular weight PE made from GUR1050 resin was irradiated at doses ranging from 0 to 200 kGy and then machined into tibial inserts followed by annealing. The knee simulator was run for up to four million cycles.

Wear and toughness of crosslinked polyethylene for total knee replacements: a study using a simulator and small-punch testing.

Severe loading and complex kinematics in total knee replacement make wear performance and toughness of the polyethylene in tibial inserts important. We investigated wear of crosslinked polyethylene using a knee simulator and measured toughness using small-punch testing. GUR1050 rods were gamma-irradiated in air at doses from 0 to 200 kGy, annealed in nitrogen, and machined into tibial inserts.

[Matrix stone: a case report].

Here, we report a case of matrix stone in a 32-year-old man with diabetes, gout, and chronic renal failure. The patient complained of pain in the left flank. He had undergone an operation for bilateral vesicoureteral reflex at the age of 17 and matrix stone discharge was repeated.

[A case of primary retroperitoneal mucinous cystadenocarcinoma].

A 41-year-old Japanese woman was admitted to our hospital for right abdominal mass. Various examinations revealed a retroperitoneal lymphangioma. Tumor resection was performed and pathological diagnosis was a mucinous cystadenocarcinoma.

High-dose glucocorticoid treatment induces rapid loss of trabecular bone mineral density and lean body mass.

A recent large-scale study revealed that glucocorticoid treatment increased fracture risk, which occurred at a far smaller dose and by a shorter duration than previously thought. To study the underlying mechanism for the increased risk of fracture, we studied the early changes in bone mineral density (BMD) and body composition by dual energy X-ray absorptiometry (DXA) after initiating high-dose glucocorticoid treatment. High-dose glucocorticoid treatment was arbitrarily defined as daily doses of >or=40 mg of a predonisolone equivalent.

A compensatory mechanism in unilateral akinetic-rigid syndrome: an fMRI study.

The motor mechanisms of a patient with unilateral hand clumsiness in the early stages of akinetic-rigid syndrome were assessed by functional magnetic resonance imaging (fMRI). Movements of the unaffected hand produced activation in the contralateral sensorimotor cortex (SMC) and ipsilateral SMC and superior parietal lobule (SPL). The affected hand activated the bilateral SMCs, supplementary motor areas, and SPLs.

[A case of postoperative chestwall recurrence of gastric cancer responding to a combination of radiation, hyperthermia and oral administration of TS-1].

A 77-year-old man diagnosed with advanced gastric cancer underwent total gastrectomy with combined splenectomy and resection of the pancreatic tails in 1996. He was treated with 400 mg/day of UFT for 2 years. Serum CEA level was found to be elevated on July 5, 2001.

Licorice-induced hypokalemia as a treatable cause of dropped head syndrome.

Isolated weakness of the extensor muscles of the neck is a relatively rare condition, known as "dropped head syndrome" (DHS). This paper reports the case of a patient with DHS whose symptoms resolved rapidly on supplementation with potassium and discontinuation of licorice consumption. To the best of our knowledge, there are no reports in the literature of DHS due to licorice-induced hypokalemia.

Purulent meningitis with unusual diffusion-weighted MRI findings.

We describe unusual findings obtained by diffusion-weighted magnetic resonance imaging (MRI) in a patient with acute purulent meningitis caused by penicillin-resistant Streptococcus pneumoniae. Along cerebral convexities and the Sylvian fissure, multiple small intense lesions showed high signal intensity in these sequences. This may be the first report of diffusion-weighted in purulent meningitis.

[A case report of a scalp dermoid cyst containing watery-clear fluid].

We report a case of a 7-month-old female with a dermoid cyst on the anterior fontanelle. She was born with a vacuum extractor. Two weeks later, her scalp on the anterior fontanelle bulged.

Interlobar lymph node metastases according to primary tumor location in lung cancer.

Interlobar lymph node metastases were analyzed in consecutive 284 lung cancer patients with lobar-hilar and mediastinal lymph node dissection. Interlobar lymph node metastases were observed in 46 (16.2%) patients with no difference between right and left cases.

Intrathecal and intraperitoneal germinomas occurring 20 years after total removal of a pineal teratoma. Case report.

In 1980, a 10-year-old boy was admitted to the authors' hospital with consciousness disturbance and vomiting. Computerized tomography (CT) scans revealed a pineal mass lesion and hydrocephalus. The tumor was totally removed and a ventriculoperitoneal (VP) shunt was inserted.

Analysis of lobar lymph node metastases around the bronchi of primary and nonprimary lobes in lung cancer: risk of remnant tumor at the root of the nonprimary lobes.

Study Objective: The details of lobar lymph node metastases at the root of nonprimary lobes (NPLs) in patients with lung cancer are still unclear.

Design: A prospective study from February 1989 to November 2000. Lobar lymph nodes in primary lobes (PLs) and NPLs were evaluated regardless of the location of the primary tumor.

Transient ischemic attack due to dissection of the middle cerebral artery--case report.

A 57-year-old man presented with a transient ischemic attack due to dissection of the middle cerebral artery. He suffered total aphasia and clouding of consciousness for several minutes. On admission, he was alert without neurological deficit.

Multiple thymoma with myotonic dystrophy.

A case of multiple thymoma associated with myotonic dystrophy is reported. The patient was a 42-year-old man who had two separate encapsulated thymoma in the anterior mediastinum, at 3 cm in diameter on the right side, and at 4 cm in diameter on the left. Extended thymo-thymomectomy was performed.

Analyses of segmental lymph node metastases and intrapulmonary metastases of small lung cancer.

Background: Curativity and indications for limited resection of small peripheral lung cancer remain controversial.

Methods: Pathologic investigations of segmental lymph node metastases and intrapulmonary metastases in the resected lobe were performed for 94 small peripheral lung cancers (3.0 cm or less in diameter).

Older boys benefit from higher initial prednisolone therapy for nephrotic syndrome. The West Japan Cooperative Study of Kidney Disease in Children.

Background: A long course of the initial prednisolone therapy has been shown to be more effective than standard-course therapy in reducing relapse rates in children with idiopathic nephrotic syndrome, but it is commonly accompanied by corticosteroid toxicities. There has been no study on prednisolone dosage for the effective treatment of nephrotic syndrome.

Methods: Sixty-eight children (42 boys and 26 girls) with an initial attack of nephrotic syndrome were randomly allocated into two different long-course treatment groups.

Multifocal micronodular pneumocyte hyperplasia in a postmenopausal woman with tuberous sclerosis.

We report a peculiar case of multifocal micronodular pneumocyte hyperplasia (MMPH) without association of pulmonary lymphangioleiomyomatosis (LAM) in a 56-year-old postmenopausal woman with tuberous sclerosis. This case is surmised to be a forme fruste of tuberous sclerosis. Computed tomography demonstrated multiple micronodules, measuring up to 5 mm in size, present in the bilateral lung fields, but no cystic changes.

[Multiple nodular pulmonary amyloidosis with multiple bullae].

We report a case of multiple nodular amyloidosis accompanied by multiple emphysematous bullae. The patient was a 72-year-old nonsmoking woman who presented with chronic cough and had a history of pneumothorax. Chest computed tomography disclosed multiple nodules up to 1 cm in diameter, and multiple small emphysematous bullae predominantly distributed in the middle and lower lung fields.