Comparative Genomics of the Mucoid and Nonmucoid Strains of Streptococcus pyogenes, Isolated from the Same Patient with Streptococcal Meningitis.

Mucoid (MTB313) and nonmucoid (MTB314) strains of group A streptococcus emm type 1 were simultaneously isolated from a single patient suffering from streptococcal meningitis. Whole-genome sequencing revealed that MTB313 carried a nucleotide substitution within rocA, which generated an amber termination codon.

Invasive aspergillosis in the aortic arch with infectious Aspergillus lesions in pulmonary bullae.

A patient with pulmonary bullae died of massive hemoptysis. At autopsy a hole was observed in the aortic wall. A microscopic examination indicated small Aspergillus lesions in pulmonary bullae and extensive necrotic lesions with Aspergillus hyphae in the media of the thoracic aorta.

Torcular dural arteriovenous fistula treated via stent placement and angioplasty in the affected straight and transverse sinuses: case report.

The successful obliteration of torcular dural arteriovenous fistula (DAVF) with a diffuse shunt in the affected sinus may require complex treatment strategies. Therapeutic goals include the preservation of normal venous drainage and complete obliteration of shunt flow. The authors report the case of a torcular DAVF.

Factors influencing the durability of the glucose-lowering effect of sitagliptin combined with a sulfonylurea.

We analyzed the changes of glycemic control over 12 months and the factors influencing blood glucose in 162 Japanese patients with type 2 diabetes having inadequate glycemic control despite sulfonylurea-based therapy who received add-on sitagliptin. Hemoglobin A1c (HbA1c) decreased significantly after 4 weeks of treatment, and this improvement was maintained for 1 year, although HbA1c was slightly higher in week 52 than in week 24. Comparison of the patients showing a ≥0.

Reanalysis of the Japanese experience using the combined COPD assessment of the 2011 GOLD classification.

Background: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2011 consensus report proposed a new classification system, incorporating symptoms with future risk, in subjects with chronic obstructive pulmonary disease (COPD). We hypothesized it could be applied to Japanese COPD patients.

Methods: We previously analyzed clinical factors related to 5-year mortality in 150 male outpatients with COPD.

Fatal fat embolism syndrome in a case of isolated L1 vertebral fracture-dislocation.

Although fat embolism syndrome is a well-known complication of fractures of the long bones or pelvis, fat embolism syndrome occurring subsequent to fracture of the lumbar spine is rare. We report a fatal case of fat embolism syndrome characterized by fat and bone marrow embolism that occurred 36 h after an isolated fracture-dislocation of the L1 vertebra. A postmortem examination was performed and pathological finding demonstrated fat and bone marrow tissue which were disseminated in the bilateral pulmonary arteries.

Diagnosis of pulmonary mucormycosis aiding the diagnosis of small cell lung cancer.

Mucormycosis is a rare complication in immunocompromised patients. Antemortem diagnosis of mucormycosis is difficult and often incorrect. We report a case of pulmonary mucormycosis caused by Cunninghamella bertholletiae in an elderly man with interstitial pneumonia.

[A case of multiple liver metastases of gastric cancer successfully treated by combination chemotherapy of S-1 and paclitaxel].

A 54-year-old man underwent distal gastrectomy for early gastric cancer in September 2002. CT performed 6 months after the operation revealed liver metastases, and they were resected. Hepatic arterial infusion therapy of 5-FU was performed; however, multiple liver metastases appeared in October 2003.

[Hyperlactemia during undiagnosed pheochromocytoma resection under laparoscopy].

A 51-year-old man was scheduled to undergo adrenal tumor resection. Because his general physical findings and labolatory tests were not particular, and his serum concentrations of noradrenaline and adrenaline were within normal limit, the tumor was diagnosed as nonfunctional adrenal tumor. Anesthesia was induced with propofol, fentanyl and maintained with oxygen, air, propofol and remifentanil.

[A case of pyogenic spondylitis mimicking spinal invasion of lung cancer].

A 65-year-old man who had suffered from traumatic spinal cord injury had chronic lumbar pain. He had exacerbation of lumbar pain and intermittent fever and consulted several doctors, but the cause of the lumbar pain was unknown. An orthopedic specialist took an MRI.

Body cavity fluid can induce epithelial and mesothelial differentiation from CD34 positive peripheral blood stem cells in vitro.

Objective: Primary culture of CD34 positive stem cells collected from human peripheral blood was performed with and without supplementation with concentrated ascitic fluid; morphological and immunocytochemical pictures of cultured cells were taken chronologically and compared.

Methods: CD34-positive stem cells collected from peripheral blood were cultured for 1, 24 and 48 hours. Concentrated ascitic fluid was added to the plates for the 24-and 48-hour cultures.

Multidimensional analyses of long-term clinical courses of asthma and chronic obstructive pulmonary disease.

Asthma and chronic obstructive pulmonary disease (COPD) are chronic respiratory disorders involving obstructive airway defects. There have been many discussions on their similarities and differences. Although airflow limitation expressed as forced expiratory volume in one second (FEV(1)) has been considered to be the main diagnostic assessment in both diseases, it does not reflect the functional impairment imparted to the patients by these diseases.

Clinical outcome after segmental wire fixation and bone grafting for repair of the defects in multiple level lumbar spondylolysis.

The aim of this retrospective study was to assess clinical outcomes after segmental wire fixation and bone grafting for repair of pars defects in patients with multiple-level lumbar spondylolysis. Subjects were 7 patients (5 men and 2 women, mean age 26.7 y) with multiple-level lumbar spondylolysis treated by segmental wire fixation and bone grafting at one of our affiliated institutions between 1983 and 2004.

Posterior interosseous nerve palsy related to rheumatoid synovitis of the elbow.

Posterior interosseous nerve palsy (PINP) is a rare complication of rheumatoid arthritis of the elbow. A 58-year-old woman with rheumatoid arthritis, who complained of an inability to extend her left fingers, was referred to our hospital. After a series of studies, extensor tendon ruptures were excluded, and PINP was diagnosed.

Huge extrapleural hematoma in an anticoagulated patient.

We report an unusual case of huge extrapleural hematoma in an anticoagulated patient with no apparent traumatic episode. An extrapleural hematoma (EH) was successfully treated by video-assisted thoracic surgery (VATS). If an EH is large enough to cause ventilatory or circulatory disturbances, VATS may be the first option for the management of EH.

The therapeutic outcome of minimally invasive synovectomy assisted with arthroscopy in the rheumatoid knee.

The purpose of the present study was to retrospectively evaluate the therapeutic outcome of minimally invasive synovectomy assisted with arthroscopy (MISAA). From 1995 to 2003, MISAA was performed on 30 knees of 18 rheumatoid arthritis patients. The mean follow-up period was 74.

Linear deposition of immunoglobulins and complement components on the dura in normal pressure hydrocephalus complicating systemic lupus erythematosus.

We present a case of normal pressure hydrocephalus in a 70-year-old man with previously diagnosed systemic lupus erythematosus. Histological examination demonstrated the linear deposition of IgG, IgA, IgM, C(3) and C(1q) on the dura in the absence of inflammation or thrombosis that has previously been implicated in the aetiology of elevated pressure hydrocephalus in systemic lupus erythematosus. Our results suggest that the deposition of immunoglobulins and complement may play a pivotal role in an insidious manner in the pathogenesis of normal pressure hydrocephalus in systemic lupus erythematosus.

[Radiological reporting system developed with FileMaker-Pro: cooperation with HIS, RIS, and PACS].

This article briefly describes our original radiological reporting system. This system was developed with the widely used database software FileMakerPro (ver 5.5).

Comparison of whole-body 18F-FDG PET, 99mTc-MIBI SPET, and post-therapeutic 131I-Na scintigraphy in the detection of metastatic thyroid cancer.

Unlabelled: The usefulness of fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) in differentiated thyroid cancer (DTC) has been demonstrated by many investigators, but in only a small number of studies have FDG-PET images been compared with those obtained using other non-iodine tumour-seeking radiopharmaceuticals. In most of the studies, planar imaging was performed for comparison using thallium-201 chloride or technetium-99m 2-methoxyisobutylisonitrile ((99m)Tc-MIBI). Furthermore, FDG-PET studies were not always performed in the hypothyroid state with increased levels of thyroid stimulating hormone (TSH), which are known to increase FDG uptake by DTC.

A patient with two thyroid papillary carcinomas demonstrating hot and cold lesions on 113I thyroid scintigraphy.

A 44-year-old euthyroid woman had two palpable nodules in the thyroid gland. 123I thyroid scintigraphy showed a hot nodule in the right lobe and a cold one in the left lobe. Total thyroidectomy was performed, and histopathologic examination revealed that both tumors contained papillary carcinoma.

Causes of appearance of scintigraphic hot areas on thyroid scintigraphy analyzed with clinical features and comparative ultrasonographic findings.

This study was done retrospectively to analyze the ultrasonographic (US) findings in thyroid scintigraphic hot areas (HA). Three-thousand, eight-hundred and thirty-nine consecutive patients who underwent 99mTc-pertechnetate (n = 3435) or 123I (n = 457) scintigraphy were analyzed. HA were regarded as present when the tracer concentration was greater than the remaining thyroid tissue, or when hemilobar uptake was observed.