Epidemiologic Research on Malformations Associated with Cleft Lip and Cleft Palate in Japan.

To investigate malformations associated with cleft lip and cleft palate, we conducted surveys at neonatal intensive care units (NICUs) and other non-NICU facilities and to determine whether there are differences among facilities. The regional survey investigated NICU facilities located in Oita Prefecture, including 92 patients with cleft lip and palate (CLP) or cleft palate (CP) that occurred between 2004 and 2013, and the national survey investigated oral surgery, plastic surgery, and obstetrics and gynecology facilities located in Japan, including 16,452 patients with cleft lip (CL), CLP, or CP that occurred since 2000. The incidence per 10,000 births was 4.

A rare case report of rib hemangioma mimicking a malignant bone tumor or metastatic tumor.

Hemangioma of the rib is a rare benign vascular tumor. This benign disease induces osteolytic changes, and must be distinguished from a malignant bone tumor or metastatic tumor. Definitive diagnosis is achieved by excision biopsy or histological examination after surgical resection in many cases.

Acute Pulmonary Embolism due to Paget-Schroetter Syndrome.

A 17-year-old Japanese male athlete presented to the emergency department at our hospital with a chief complaint of exertional dyspnea. Although there were no significant findings in the right and left upper extremities on a physical examination, a chest computed tomography scan showed bilateral multiple thrombosis in the pulmonary arteries, indicating pulmonary thromboembolism, and deep vein thrombosis in the left subclavian vein. Upper limb venography showed interruption of the left subclavian vein (so-called Paget-Schroetter syndrome; PSS).

Congenital toxoplasmosis from a mother with type 2 diabetes mellitus: a case report.

A 33-year-old woman with type 2 diabetes mellitus (DM) was suspected of being primarily infected with Toxoplasma gondii at 12 weeks of gestation (GW). Although acetylspiramycin was started at 17 GW, the T. gondii DNA gene was detected in the amniotic fluid at 18 GW.

Recurrent immature teratoma of the ovary with long-term disease-free interval.

Grade 3 immature teratoma of the ovary is rare and has a poor prognosis due to early recurrence. This report describes a case of grade 3 immature teratoma of the ovary that recurred 16 years after the last treatment. The patient underwent abdominal simple total hysterectomy, bilateral salpingo-oophorectomy, pelvic-para-aortic lymphadenectomy, and adjuvant chemotherapy under the diagnosis of grade 3 immature teratoma of the ovary when she was 15 years old, and complete remission was achieved.

Non-neuronal cell responses differ between normal and Down syndrome developing brains.

Down syndrome (DS), the most common genetic cause of mental retardation, is characterized by reduced number of neurons and delayed myelination. Though non-neuronal cells in the brain are vital for the development, survival, and function of neurons, there is a paucity of comparative studies of normal development and DS, in particular in the temporal lobe, a region of interest for cognitive decline. We evaluated immunoreactivity for CD68 (macrophage), HLA-DR (microglia), Olig2 and TPPP/p25 (oligodendroglia), and GFAP (astroglia) in the germinal matrix (GM), temporal lobe white matter (TeWM) and hippocampus from 14 weeks of gestations to newborn in 28 DS patients and 30 age-matched controls.

Successful perioperative management of a patient with idiopathic thrombocytopenic purpura undergoing emergent appendectomy: Report of a case.

Introduction: Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disease characterized by a low platelet count and normal bone marrow. Patients with ITP undergoing surgery are thought to have increased risk for postoperative complications because of their thrombocytopenia.

Presentation Of Case: we report the case of a 66-year-old woman with ITP who required an emergency operation for acute appendicitis associated with disseminated intravascular coagulation.

Effect of eicosapentaenoic acid agent on aggravated hypertriglyceridemia during pregnancy.

Aggravated hypertriglyceridemia with a serum triglyceride of more than 1000 mg/dL is a risk of acute pancreatitis during pregnancy. However, there have been few reports on the administration of an eicosapentaenoic acid (EPA) agent for aggravated hypertriglyceridemia during pregnancy. A 29-year-old multiparous Japanese woman was transferred to our hospital at 29 + 0 weeks of gestation due to hypertriglyceridemia of 898 mg/dL.

Laparoscopy-assisted distal gastrectomy for early gastric cancer with versus without prophylactic drainage.

Purpose: Little has been reported on routine prophylactic abdominal drainage after gastrectomy, especially after laparoscopy-assisted distal gastrectomy (LADG). We conducted this retrospective study on patients undergoing LADG to evaluate the benefit of routine drainage in LADG procedures.

Methods: The subjects were 21 patients who underwent surgery for early gastric cancer (EGC) between January 2004 and March 2008.

Laparoscopic cholecystectomy with and without abdominal prophylactic drainage.

Aim: As techniques in laparoscopic cholecystectomy (LC) have improved, the role of routine prophylactic abdominal drainage may be limited. A retrospective review was carried out of patients undergoing elective LC to evaluate the benefit of routine drainage in simple uncomplicated procedures.

Methods: This study of 295 patients with cholecystolithiasis or gallbladder polyp included 145 patients who underwent LC with drainage and 150 patients who underwent LC without drainage between 2003 and 2007.

A case of retroperitoneal mucinous cystadenoma treated successfully by laparoscopic excision.

A case of retroperitoneal mucinous cystadenoma treated laparoscopically is reported. A 26-year-old woman, who complained of abdominal fullness, was referred to us after a large intra-abdominal mass was discovered at her local hospital. Ultrasound and computed tomography showed a fluid-filled mass, 9 cm in diameter, in the left retroperitoneal space.

Spontaneous internal oblique hematoma successfully treated by transcatheter arterial embolization.

Abdominal wall hematoma is an uncommon cause of acute abdominal pain. We report a case of internal oblique hematoma caused by rupture of the subcostal artery in a 57-year-old woman. Ultrasonography (US) showed a hypoechoic mass in the right lateral abdominal wall.

Paternal transmission and slow elimination of mutant alleles associated with late-onset ornithine transcarbamylase deficiency in male patients.

In ten families with late-onset ornithine transcarbamylase (OTC) deficiency in male patients, three mutant alleles-R40H, R277W, and Y55D-were identified. In a total of 20 informative parent-offspring pairs, father-to-daughter transmission and mother-to-offspring transmission occurred in five (25%) and 15 (75%), respectively, indicating that paternal transmission contributes substantially to the pool of these mutant alleles. Relative reproductive fitness of males and females carrying the mutant alleles was calculated to be 0.

Large mucinous cystadenoma of the pancreas during pregnancy: report of a case.

A 33-year-old woman, gravida 2, para 1, was diagnosed to have a benign mucinous cystic neoplasm of the pancreas 5 months before delivery. The tumor measured 12 cm in diameter at the time of diagnosis. The antenatal course was uneventful, and a vaginal delivery produced a normal infant.

Hepatocellular carcinoma producing a granulocyte colony-stimulating factor: report of a resected case with a literature review.

A complete resection of a hepatocellular carcinoma (HCC) producing the granulocyte colony-stimulating factor (G-CSF) was performed and is reported here. The patient had a few general symptoms and complications, such as the paraneoplastic syndrome. He had marked granulocytosis, and his serum levels of G-CSF and interleukin-6 were elevated.

Successful conservative treatment of a bicycle-handlebar hernia: report of a case.

Handlebar hernia is a rare type of blunt traumatic abdominal wall hernia (TAWH). It involves a disruption of the abdominal wall muscles, with bowel loop herniation through the defect in the abdominal wall. We report a case of bicycle-handlebar hernia in a 9-year-old boy who had all layers of his abdominal wall disrupted after falling from his bicycle.

Implications of arterial anatomy in patients with cancer of the periampullary region.

Background/aims: Preoperative information on arterial anatomy in the peripancreatic and hepatic areas is valuable to any surgeon performing pancreatoduodenectomy.

Methodology: Between 1994 and 1998, 49 patients with periampullary cancer (31 distal bile duct and 18 ampullary tumors) underwent visceral angiography and radical pancreatoduodenectomy with lymphadenectomy. Surgically "significant" arterial variations and their effects on operative management and results were examined retrospectively.

Double duct-to-mucosa pancreaticojejunostomy for bifid pancreatic duct.

We report a pancreaticojejunostomy with double duct-to-mucosa anastomotic technique after pyloruspreserving pancreaticoduodenectomy for chronic pancreatitis with bifid pancreatic duct. A 49-year-old Japanese man was diagnosed preoperatively as having chronic pancreatitis with common bile duct stricture and pseudocyst of the pancreatic head. In a pancreaticoduodenectomy, the main pancreatic duct (7mm in diameter) and a secondary pancreatic duct (4mm in diameter) were identified intraoperatively at the transected surface.

[Pulmonary undifferentiated carcinoma associated with severe inflammatory response; report of 2 cases].

We present 2 cases with pulmonary undifferentiated carcinoma accompanying severe inflammatory responses. Both patients initially complained high-grade fever. Laboratory data on admission showed leukocytosis and elevation of serum CRP level.

[UFT plus cisplatin with concurrent radiotherapy in unresectable stage III non-small cell lung cancer--its application to outpatient practice].

Background: Combination chemotherapy with UFT and cisplatin is active and less toxic for advanced non-small cell lung cancer. This treatment is likely to be applied to concurrent chemoradiotherapy for locally advanced non-small cell lung cancer, especially in the outpatient setting.

Patients And Methods: Ten patients with unresectable stage III non-small cell lung cancer received the UFT plus cisplatin treatment combined with concurrent radiotherapy.

Dihydropyrimidine dehydrogenase levels in nonsmall-cell lung cancer tissues.

Background: Dihydropyrimidine dehydrogenase (DPD) activity in tumor tissues is thought to play an important role in the antitumor effect of 5-fluorouracil (FU). In order to define 5-FU-resistant nonsmall-cell lung cancer, we assessed the DPD level in tumor tissues with an enzyme immunoassay.

Methods: Using a sandwich enzyme immunoassay, the DPD level in lung cancer tissues was quantitatively measured in 52 patients with primary lung cancer who had undergone a pulmonary lobectomy.

Staging with helical computed tomography and laparoscopy in pancreatic head cancer.

Background/aims: Helical computed tomography provides valuable information about extent of pancreatic cancer. However, it remains difficult to detect small distant metastases. Laparoscopic examination is becoming standard for cancer staging.

[A review of Japanese literatures concerning surgery for lung cancer with idiopathic interstitial pneumonia].

Objective: The aim of the present study is to investigate the perioperative management of acute exacerbation of idiopathic interstitial pneumonia (IIP) after pulmonary resection for lung cancer.

Methods: We reviewed 5 Japanese literatures published from 1992 through 1998. The present study included 50 lung cancer patients with IIP, of which 3 were our cases and 47 were reported cases.