Repair of the aortico-left ventricular tunnel originating from the right aortic sinus with severe aortic valve regurgitation.

A 31-year-old adult with an aortico-left ventricular tunnel (ALVT) arising from the right aortic sinus is reported. Preoperative transesophageal echocardiography demonstrated a ruptured sinus of Valsalva with severe aortic valve regurgitation which originated from the right coronary sinus entering the outlet portion of the left ventricular outflow tract. Operation revealed the aortic entrance of the tunnel was above the right coronary sinus.

[A case of bilateral neonatal testicular torsion].

We report a case of bilateral synchronous testicular torsion in a newborn. A male neonate was referred one day after birth because his left testis was firm and enlarged. We found that the scrotum was firm bilaterally and suspected it to be bilateral testicular tumor.

CT features of chronic contained rupture of an abdominal aortic aneurysm.

Four cases among the 149 patients who required repair of an infrarenal abdominal aortic aneurysm (AAA) during the last five years, were chronic contained rupture. The first symptom at onset was back pain and physical examination revealed the patients to be in no acute distress. The sites of rupture were posterior in all cases.

Chronic intestinal pseudoobstruction ileus in a patient with rheumatoid arthritis: outcome of a stoma construction and its histopathological features.

We report the first case of a chronic intestinal pseudoobstruction (CIPO) in a patient with rheumatoid arthritis (RA) in whom a stoma was constructed at the sigmoid colon to decompress intracolonic pressure. The treatment improved quality of life in this patient, suggesting that surgical resection of the colon to decompress intracolonic pressure would be one of the options for the treatment of intractable CIPO. The resected specimen obtained from the sigmoid colon was found to be palisaded, with nuclei crowded in some areas of the inner circular muscle layer and thickened, with zonal or focal myxoid regions with interstitial fibrosis, composed of collagenous and elastic fibers, in the outer longitudinal muscle layer.

Detection and monitoring of methotrexate-associated lung injury using serum markers KL-6 and SP-D in rheumatoid arthritis.

The applicability of monitoring concentrations of serum KL-6 and serum surfactant protein-D (SP-D) in the detection of methotrexate-associated lung injury (MTX pneumonitis) in patients with rheumatoid arthritis (RA) was investigated. The concentrations of these markers, sequentially measured in two patients with RA complicated with MTX pneumonitis, were increased in accordance with the severity of MTX pneumonitis. Conversely, the concentrations of these markers were decreased with the improvement of MTX pneumonitis, suggesting that the monitoring of these markers could be applicable not only for detecting the onset of MTX pneumonitis, but also for detecting the therapeutic response of MTX pneumonitis.

A patient with Wegener's granulomatosis with initial clinical presentations of Henoch-Schönlein purpura.

The initial presentation of a patient with Wegener's granulomatosis was indistinguishable from that of Henoch-Schönlein purpura. The patient presented with skin purpura and pulmonary hemorrhage followed by purpura in the colon. The diagnosis of this patient at that time was Henoch-Schönlein purpura.

[Evaluation of chemotherapy with docetaxel and cisplatin in advanced non-small cell lung cancer].

Clinical study has been conducted to evaluate the efficacy of chemotherapy with docetaxel and cisplatin in six patients with advanced non-small cell lung cancer. Treatment schedule consisted of docetaxel 60 mg/m2 and cisplatin 80 mg/m2 on day 1 and repeated every 4 weeks. Eligible patients had histologically proven locally advanced or metastatic non-small cell lung cancer, PS < or = 2, age < or = 74, normal hematological, hepatic and renal functions and informed consent in writing.

The natural history of radiographic instability of the lumbar spine.

The natural history of radiographic instability of the lumbar spine was determined by reexamination of 50 patients who had been diagnosed with this condition at least 10 years previously and correlation of these findings with changes in the clinical condition. The initial diagnosis and follow-up examination was performed by dynamic radiography, and the following observations were made: 1) radiographic instability resolved spontaneously in 20% of cases; 2) radiographic instability due to isolated posterior opening (asymmetric anterior collapse of the intervertebral disc in flexion) usually was self-limited; and 3) combined posterior opening and forward translation in flexion was associated with chronic instability and debilitating symptoms. The functional prognosis, whether or not symptoms are improved, in patients with radiographic lumbar instability depends primarily on developmental narrowing of the spinal canal, rather than on the existence or type of radiographic instability.