[A case of pulmonary sarcoidosis with usual interstitial pneumonia-like lesions distributed predominantly in the lower lung fields].

In 2000, in a 75-year-old man, nodular and reticular opacities were detected in both lower lung fields. He was admitted to our hospital for further examination of these abnormal shadows. Bronchoscopic examination revealed pulmonary sarcoidosis.

[Study of optimal imaging parameters for digitally reconstructed radiographs (DRR) in radiotherapy treatment planning using single-slice helical CT].

In recent years, by making digitally reconstructed radiographs (DRR) from helical CT images in the position check of an irradiation field, the verification performed by DRR, lineacgraphy (LG), or an electronic portal imaging device (EPID) has become possible. We examined the optimal parameters of single-slice helical scanning in DRR image construction and the usefulness of DRR replaced with the simulation film. We performed a section sensitivity profile at the Z-axis (SSPz) as evaluation of a physical characteristic of helical CT equipment and the form of image of DRR, fixed quantity evaluation of imaging distortion, and visual verification of images.

Dynamic CT of acute cholangitis: early inhomogeneous enhancement of the liver.

Objective: Our objective was to describe the dynamic CT findings of acute cholangitis, especially early inhomogeneous enhancement of hepatic parenchyma.

Materials And Methods: Inhomogeneous enhancement of hepatic parenchyma was retrospectively evaluated on dynamic CT in 406 consecutive patients without irregular fatty liver or multiple hepatic tumors. Dynamic CT scans were obtained 30 sec (early phase) and 90 sec (late phase) after starting the contrast material injection.

Endobronchial occlusion method of bronchopleural fistula with metallic coils and glue.

We describe our technique for endobronchial occlusion of bronchopleural fistula (BPF) with metallic coils and glue through a fiber-optic bronchoscope under local anesthesia. After anchoring the vascular embolization coils at the fistula bronchus, cyanoacrylate glue was sprayed. The sprayed glue obliterates gaps between the coils and stabilizes them.

Use of three-dimensional computed tomographic angiography of pulmonary vessels for lung resections.

Background: Identification and appropriate treatment of the pulmonary artery (PA) is a key to successful anatomic resection of the lung. Preoperative identification of branching pattern of the PA seems to make pulmonary resection easier and safer especially when there is severe adhesion or incomplete fissure between the lobes. With the development of the multidetector row spiral computed tomography (MDCT), three-dimensional (3D) CT angiography can be obtained easily and can provide very useful information about various organs.

Diffuse mucosal carcinoma of intrahepatic and extrahepatic bile ducts including gallbladder.

An autopsy case with a widespread mucosal carcinoma of the biliary tree was reported. A biochemical profile of the bile duct damage was noticed in a woman in her seventies during a gastric examination. Imaging procedures depicted irregular dilatations of intrahepatic bile ducts with a bead-like appearance.

Results of wedge resection for focal bronchioloalveolar carcinoma showing pure ground-glass attenuation on computed tomography.

Background: Focal bronchioloalveolar carcinoma (BAC) showing pure ground-glass attenuation (GGA) on thin-section computed tomography (CT), which is considered to be an early-stage adenocarcinoma, has been diagnosed with increasing frequency due to the development and spread of the helical CT scanner. We discussed the appropriateness of limited resection for this type of lesion.

Methods: Between July 1996 and June 2001, 17 patients with localized BAC showing "pure GGA" (GGA without central scar formation) on thin-section CT underwent limited pulmonary resections.

Reasons for the delays in the definitive diagnosis of lung cancer for more than one year from the recognition of abnormal chest shadows.

Objective: Primary lung cancer generally has a poor prognosis if not diagnosed at an early stage. But some lung cancers grow very slowly. In particular, adenocarcinoma is sometimes observed for years with no change of tumor size.

[A case of transitional cell carcinoma of the bladder with active urinary tract tuberculosis].

A 63-year-old man was admitted to our hospital complaining of painful urination. Urinalysis demonstrated pyuria and microscopic hematuria. Cystoscopy revealed the bladder tumor and the reddish mucosa.

Renal involvement induced by human parvovirus B19 infection.

In an attempt to clarify the renal involvement induced by human parvovirus B19 (HPB19) infection, we investigated 6 adult patients with transient urinary abnormalities followed by erythema infectiosum. All patients had HPB19-specific IgM antibody and showed mild proteinuria of 0.2-1.

[A case of pneumonia, septic pulmonary embolisms with cavities, bilateral large lung abscesses, and multiple liver abscesses caused by Klebsiella pneumoniae].

A 64-year-old man suffering from diabetic hyperosmolar non-ketotic coma was admitted for acute lung abscess in the left apical lung field. Sputum culture and blood culture showed a heavy growth of Klebsiella pneumoniae (K. pneumoniae).

[Low dose melphalan therapy was effective in an elderly patient with MDS-AML].

An 80-year-old man with MDS-refractory anemia (RA) suffered transformation to a leukemic state after 18 months. The karyotype of the bone marrow cells was 47, XY, +8 in 8 cells among 20 dividing cells analyzed. Combination therapy of 150 micrograms of granulocyte colony-stimulating factor (G-CSF) and 250 mg of cytarabine ocfosfate (SPAC) for 3 weeks had no beneficial effect.

Successful treatment of B-cell lymphoma associated with hemophagocytic syndrome using autologous peripheral blood CD34 positive cell transplantation followed by induction of autologous graft-versus-host disease.

A 56-year-old man who presented with persistent high fever and abdominal pain was diagnosed as having a B-cell lymphoma associated with hemophagocytic syndrome (B-LAHS). As post-remission therapy, the patient was treated with high-dose chemoradiotherapy followed by infusion of autologous CD34+ cells that had been isolated from the peripheral blood buffy coat. Cyclosporin and interferon (IFN)-gamma were administered to induce autologous graft-versus-host disease (GVHD).

Successful therapy of myelodysplastic syndrome with menatetrenone, a vitamin K2 analog.

Although vitamin K2 is an inducer of the in vitro differentiation of myeloid leukemic cell lines, its clinical efficacy in the treatment of myelodysplastic syndrome (MDS) is unclear. We administered a vitamin K2 analog, menatetrenone, at 45 mg daily to an 80-year-old woman with MDS (refractory anemia) heavily dependent on red-cell transfusions. The patient's pancytopenia gradually improved, and she became transfusion-independent after 14 months.

Impaired response of granulocyte-committed progenitor cells to stem cell factor and granulocyte colony-stimulating factor in human cyclic neutropenia.

Although cyclic neutropenia (CN) has been the subject of extensive studies due to its striking clinical picture, the abnormality of hematopoietic progenitor cells in patients with CN has been poorly defined. We studied the sensitivity of progenitor cells of a CN patient to colony-stimulating factors (CSF) including G-CSF, interleukin-3 (IL-3), and stem cell factor (SCF). Peripheral blood progenitor cells of the patient required a significantly higher dose of G-CSF to give rise to colonies than those of normal controls.

Light chain deposition disease detected by antisera to a variable region of the kappa1 light chain subgroup.

A 59-year-old male started maintenance hemodialysis, and 80 months later died of congestive heart failure. Just before death he had no urine, and no monoclonal immunoglobulin could be demonstrated in the serum on immunoelectrophoresis. An autopsy showed deposition of periodic acid-Schiff-positive and Congo red-negative material in the interstitium and vessel walls of almost all organs and tissues.

Methylprednisolone pulse therapy in two clinical types of crescentic glomerulonephritis.

To clarify the effectiveness of methylprednisolone pulse therapy on crescentic glomerulonephritis (CresGN), data of 46 patients was retrospectively studied. According to the slope of reciprocals of serum creatinine (s-Cr) the patients were divided into acute and insidious types, and each type was further divided into pulse (P) and conventional (C) therapy groups. In group C, s-Cr improved more frequently in the acute type (8/10) than in the insidious type (1/9, p<0.

[17-ketosteroid sulfates and its application to kampo-medicine].

Traditional oriental medicine tells us that everything is interrelated and consists of combinations of opposing factors, "Yin-Yang". So we need to evaluate the normal state and pathologic condition from the perspective of dynamic hormone balance between cortisol and DHEA which are opposing and physiologically very important. Cortisol has a more functional side and is considered Yang, while DHEA has a more material side and is considered Yin.

[Obesity and disturbance of sexual function].

Insulin-resistance is a central character of the simple obesity, resulting from decrease of the insulin receptor and dysfunctions of the post receptor systems. It induces hyper-insulinemia. Excess insulin gives rise to the synthesis of androgens by binding to the receptor of the ovary, and suppresses the SHBG and IGFBG in the liver.

[Effects of methylprednisolone pulse therapy in the insidious type of crescentic glomerulonephritis].

In a attempt to clarify the effects of methylprednisolone pulse therapy on the insidious (subacute) type of crescentic glomerulonephritis with slow, but steady deterioration of renal function and poor response to treatment, we analyzed the clinical course of 24 patients (male:female = 15:9) with a mean age of 48.5 years. They fulfilled the following criteria: 1) crescents were observed in more than 50% of the glomeruli, 2) the increment of serum creatinine (Cr) could be determined sequentially on three or more occasions before treatment, and reciprocals of serum Cr declined with slopes of less than 1.

[Legionella pneumonia successfully treated despite late diagnosis].

Status asthmaticus developed in a 72-year-old man who was being treated with oral prednisolone for severe persistent asthma. The dosage of prednisolone was increased, and amikacin was injected to treat pneumonia that had developed in the right lung. Progressive pulmonary infiltrates, respiratory compromise, and hypoxemia developed, and the patient eventually required mechanical ventilation.