[Ictal semiology in patients with medial temporal lobe epilepsy: value in lateralizing the seizure focus].

We have evaluated useful lateralizing signs in 28 patients with medial temporal lobe epilepsy who were seizure-free after anterior temporal lobectomy by reviewing videotapes during video-EEG monitoring. The most frequent types of aura were epigastric sensation and psychic symptom in 8, respectively, both of which did not predict lateralization of the focus. Of the motor signs, early head deviation and unilateral upper extremity automatism predicted an ipsilateral focus in 72 and 80%, respectively.

[The present state and problems of HCV blood screening system in blood products].

After discovering HCV antibody in 1989, the new cases of posttransfusion hepatitis C has been rare. This HCV antibody screening system provided certainly the powerful preventive effect from HCV infection through blood products. But it was possible to infect HCV through the blood products without HCV antibody but with HCV-RNA.

Mixed connective tissue disease associated with von Recklinghausen's neurofibromatosis.

We report a 42-year-old Japanese woman with Recklinghausen's neurofibromatosis 1 (NF1) who developed mixed connective tissue disease (MCTD). Previously experiencing good health without an increase in subcutaneous nodules, she presented with Raynaud's phenomenon, swollen hands and polyarthralgia Clinical examination revealed a high titer of anti-RNP antibody, and she was thus diagnosed as having MCTD. She was treated with oral prednisolone (10 mg/day) and her symptoms improved rapidly.

Recurrent leg ulcers and arterial thrombosis in a 33-year-old homozygous variant of antithrombin.

We report here a homozygous variant case of antithrombin (AT) associated with arterial thrombosis and recurrent leg ulcers. The deep vein thrombosis was recognized by the venogram of his pelvic veins. His leg ulcers were scattered around his left ankle and accompanied by lipodermatosclerosis, which was evident in venous insufficiency.

Successfully treated descending necrotizing mediastinitis through mediansternotomy using a pedicled omental flap.

A 21-year-old man with an oropharyngeal abscess admitted to our institution was initially treated with systemic antibiotics but was referred to our department when his condition rapidly deteriorated. His respiratory insufficiency required circulatory support. A computed tomographic scan showed a parapharyngeal abscess descending into the mediastinum with multiple right-side capsulized empyema and pericardial effusion.

Primary biliary cirrhosis associated with idiopathic retroperitoneal fibrosis.

Idiopathic retroperitoneal fibrosis (IRF) and primary biliary cirrhosis (PBC) are distinct clinical disorders which rarely occur in the same patient. We report a 79-year-old man with the coexistence of both conditions. The patient had antibodies to both centromere and mitochondria, as indicated by indirect immunofluorescence.

Natural history of chronic hepatitis C.

The natural history of chronic hepatitis C is one of a slow progression from early stage chronic hepatitis without fibrosis to cirrhosis or hepatocellular carcinoma (HCC). The disease progresses to advanced stage chronic hepatitis C over 10-30 years. Data from Japan indicate that mortality associated with chronic hepatitis C results mainly from the development of HCC.

[A case of adenoid cystic carcinoma of the trachea resected surgically after Nd-YAG laser therapy].

A case of primary tracheal tumor ablated by endoscopic Nd-YAG laser prior to tracheal sleeve resection was reported. A 53-year-old man had dry cough, bloody sputum and dyspnea. Bronchoscopic examination revealed polypoid tumor which located 2 cm below the vocal cords and obstructed the airway almost completely.

Effect of alcohol consumption on the progression of hepatitis C virus infection and risk of hepatocellular carcinoma in Japanese patients.

Chronic hepatitis C virus (HCV) infection is associated with a spectrum of liver diseases and a proportion of chronic cases progress through cirrhosis to hepatocellular carcinoma (HCC). The viral and host factors that are important in the clinical and histological progression of HCV infection are unclear. We investigated the effect of moderate (<80 g/day) and heavy (>80 g/day) alcohol intake on the histological and clinical progression of HCV infection and their associated risk of hepatic cancer in a group of Japanese patients.

Detection of HBV RNA in peripheral blood mononuclear cells in patients with and without HBsAg by reverse transcription polymerase chain reaction.

We examined RNA of hepatitis B virus (HBV) in peripheral blood mononuclear cells (PBMCs) by the reverse transcription polymerase chain reaction (RT PCR) in 61 patients associated with HBV infection, in order to analyze the relationship between the transcriptional activity of HBV in PBMCs and the clinical characteristics. The presence of HBV RNA in PBMCs was detected in 19/51(37.1%) patients with HBsAg positive and in 1/10 (10.

Proposed abdominal sonographic staging to predict severity of liver diseases: analysis with peritoneoscopy and histology.

Abdominal sonography is a routinely used noninvasive modality for screening and treatment of liver diseases. We attempted to establish a morphological sonographic staging to predict the severity of liver diseases with their consequent analysis with morphological staging of peritoneoscopy and histology. In all, 136 patients were enrolled for the final confirmation of disease state by peritoneoscopy and histology preceded by abdominal sonography.

Prospective analysis of risk factors for early intrahepatic recurrence of hepatocellular carcinoma following ethanol injection.

Background/aim: Time-dependent intrahepatic recurrence of hepatocellular carcinoma is frequent after different treatment modalities, including percutaneous ethanol injection. We attempted to prospectively analyze the possible risk factors for early intrahepatic recurrence of hepatocellular carcinoma after percutaneous ethanol injection.

Methods: Sixty-five patients with 65 solitary hepatocellular carcinoma nodules < or =6 cm in diameter underwent initial treatment with percutaneous ethanol injection and were examined to ascertain the factors related to recurrence, local and distant, within the liver.

[A case of mediastinal mature teratoma accompanying elevated CA 19-9 and CEA in the cystic fluid].

Fourteen year old female visited our hospital suffering from anterior chest pain. Chest CT revealed anterior mediastinal mass which had multiple cystic lesions, 8.5 x 7.

Response of skin blood volume, velocity and flow to local warming in newborns, measured by laser Doppler flowmetry.

Background: In order to know the response of the skin microcirculation to local warming, we determined changes in the skin blood volume (Vol), velocity (Vel) and flow (F) by using a new laser Doppler device on newborns.

Methods: The study subjects were 39 infants whose gestational age was 34.1 +/- 2.

Prevalence and clinical characteristics of TT virus (TTV) in patients with sporadic acute hepatitis of unknown etiology.

Background/aims: Recently, a novel DNA virus was isolated from the serum of a patient with post-transfusion non-A-G hepatitis and named TT virus. The aim of this study was to determine the prevalence and clinical characteristics of TT virus infection in patients with sporadic acute hepatitis of unknown etiology.

Methods: TT virus was investigated in the serum of 66 patients with sporadic acute hepatitis non-A-G and 50 healthy controls by semi-nested PCR with previously published primers.

[CT findings of non-traumatic colorectal perforation].

We retrospectively analyzed CT scans from 23 patients with non-traumatic colorectal perforation. We compared the sensitivity of CT and plain film radiography in the detection of free gas. Free gas was observed in 7 of the 23 cases (30.

Pericardio-peritoneal drainage using a subcostal approach.

A 56-year-old man admitted to our hospital for cardiac tamponade due to dilated cardiomyopathy did not respond to treatment by usual medical means or surgery. Pericardio-peritoneal drainage was conducted using a subcostal approach. Seven months later, the patient remains well and free of signs of pericardial tamponade.

Immunohistochemical analysis of hepatic interferon alpha-beta receptor level: relationship between receptor expression and response to interferon therapy in patients with chronic hepatitis C.

Background/aims: This study aimed to determine the expression level of interferon alpha/beta (IFN-alpha/beta) receptor in the liver immunohistochemically and evaluate its usefulness in predicting the outcome to IFN therapy in patients with chronic hepatitis C.

Methods: The level of IFN-alpha/beta receptor expression was determined in immunoperoxidase-stained pretreatment sections of 55 chronic hepatitis C patients later treated with IFN. We used liver biopsy specimens and mouse monoclonal anti-human IFN-alpha/beta receptor antibody.

[Clinical characteristics and incidence in acute non A-G hepatitis].

We investigated clinical characteristics and incidence of patients with acute non-A-G hepatitis, who were all registered in 17 Japanese National Hospitals. Seven hundreds thirty-one (24.0%) of 3052 patients with sporadic acute hepatitis and 73 (21.

Bronchoscopic therapy for mucosa-associated lymphoid tissue lymphoma of the trachea.

The tracheal tumor of a 74-year-old female was detected on bronchoscopy and histologically diagnosed as mucosa-associated lymphoid tissue (MALT) lymphoma. We successfully treated the tumor with endoscopic neodyminum-yttruim-aluminium-garnet (Nd-YAG) laser photoresection followed by local ethanol injection. This is the first case in which tracheal MALT lymphoma was successfully treated with bronchoscopy.

Association of mutations in the core promoter and precore region of hepatitis virus with fulminant and severe acute hepatitis in Japan.

It was recently reported that mutations in the precore and core promoter region of hepatitis B virus (HBV) are associated with fulminant hepatitis. The aim of this study was to investigate the association of mutations in the precore and core promoter region of HBV with fulminant and severe acute hepatitis. We studied Japanese patients with acute HBV infection, including seven patients with fulminant hepatitis, 12 with severe acute hepatitis and 41 with acute self-limited hepatitis.