Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies.

Background: The decision of whether to treat incidental intracranial saccular aneurysms is complicated by limitations in current knowledge of their natural history. We combined individual patient data from prospective cohort studies to determine predictors of aneurysm rupture and to construct a risk prediction chart to estimate 5-year aneurysm rupture risk by risk factor status.

Methods: We did a systematic review and pooled analysis of individual patient data from 8382 participants in six prospective cohort studies with subarachnoid haemorrhage as outcome.

Coexistence of familial Mediterranean fever and rheumatoid arthritis.

Familial Mediterranean fever (FMF) is an autoinflammatory disorder characterized by recurrent febrile polyserositis and arthritis. Although accompanying seronegative spondyloarthropathy has been reported in FMF, coexistence with rheumatoid arthritis (RA) is very rare. This case report describes a Japanese female RA patient who presented with periodic fever.

Tetanus following replantation of an amputated finger: a case report.

Introduction: Tetanus is an infectious disease caused by tetanus toxin produced by Clostridium tetani and induces severe neurological manifestations. We treated a patient who developed tetanus during hospitalization for replantation of an amputated finger. To the best of our knowledge, this is the first published case report of such an entity.

Quality of pediatric second-degree burn wound scars following the application of basic fibroblast growth factor: results of a randomized, controlled pilot study .

Pediatric burn wounds present unique challenges. Second-degree burns may increase in size and depth, raising concerns about healing and long-term scarring. Results of a clinical study in adults with second-degree burn wounds suggest that application of basic fibroblast growth factor (bFGF) may reduce time to second-intention healing and result in a more cosmetically acceptable scar.

Epstein-Barr virus and methotrexate-related CNS lymphoma in a patient with rheumatoid arthritis.

Patients with rheumatoid arthritis (RA), especially those treated with methotrexate (MTX), might have an increased risk of lymphoproliferative disorders that are associated with Epstein-Barr virus (EBV). We describe a case of EBV-associated central nervous system (CNS) lymphoma (diffuse large B-cell lymphoma) in a patient with RA on a short course of MTX treatment. The neoplastic cells express the B-cell surface markers (CD20, Pax-5 and CD30), and EBV-encoded RNA was demonstrated by in situ hybridization.

Coexistence of polymyositis and familial Mediterranean fever.

Familial Mediterranean fever (FMF) is an autosomal recessive disease affecting populations surrounding the Mediterranean area. In this case report, we report a Japanese female patient with polymyositis (PM) who presented with periodic fever. Genetic analysis revealed that she had compound heterozygous mutations in exon 2 of the MEFV gene (L110P/E148Q/R202Q).

Leukocytapheresis (LCAP) for treating refractory adult-onset Still's disease (AOSD).

This is the first report on the efficacy of leukocytapheresis (LCAP) in a patient with refractory systemic-type adult-onset Still's disease (AOSD). A 17-year-old Japanese woman with AOSD who had been treated with prednisolone and cyclosporine A presented with relapse of typical systemic AOSD, including high fever, rash, and liver dysfunction. Steroid pulse therapy (methylprednisolone 500 mg/day) was performed, which failed to stabilize the disease.

Thyroid papillary carcinoma with solid sclerosing change in IgG4-related sclerosing disease.

IgG4-related sclerosing disease (IgG4-RSD) is an inflammatory and fibrosing disorder characterized by lymphoplasmacytic inflammation with infiltration of various organs, including the pancreas, bile ducts, lung, kidney, and retroperitoneum. As for malignancy in IgG4-RSD, only limited literature is available. We report here a case of thyroid papillary carcinoma showing unique morphology in IgG4-RSD.

Successful treatment of HTLV-1-related overlap syndrome using tacrolimus.

A 56-year-old HTLV-I-positive woman, initially diagnosed as having Sjögren's syndrome, presented with muscle weakness, myalgia, face erythema and leg edema. Based on the presence of various autoantibodies, the diagnosis of overlap syndrome (dermatomyositis/Sjögren's syndrome) was made. Treatment with high-dose corticosteroid plus cyclosporine improved her symptoms.

[Occurrence of organizing pneumonia after radiation therapy for postoperative breast cancer].

Three cases of organizing pneumonia (OP) that occurred after planned radiation therapy for postoperative breast cancer are reported. All patients received tangential radiation therapy and adjuvant tamoxifen (TAM) for postoperative breast cancer. Two patients developed fever and cough; one was asymptomatic.

A case of lupus-associated pancreatitis with ruptured pseudoaneurysms.

Pancreatitis is a relatively rare complication in systemic lupus erythematosus (SLE). Herein we report a case of SLE with the initial development of acute pancreatitis, subsequently complicated by bleeding pseudoaneurysms. A 55-year-old Japanese woman was admitted to our hospital for the treatment of SLE.

The incidence of hepatocellular carcinoma associated with hepatitis C infection decreased in Kyushu area.

Background: The incidence of hepatocellular carcinoma (HCC) in Japan has still been increasing. The aim of the present study was to analyze the epidemiological trend of HCC in the western area of Japan, Kyushu.

Material/methods: A total of 10,010 patients with HCC diagnosed between 1996 and 2008 in the Liver Cancer study group of Kyushu (LCSK), were recruited for this study.

Callosotomy and subsequent surgery for children with refractory epilepsy.

Callosotomy has been considered as a palliative therapy for refractory epilepsy patients with non-focal onset seizures. Residual partial seizures and unilateral epileptiform discharges on electroencephalography (EEG) are sometimes observed after callosotomy. These findings suggest that some patients may be candidates for subsequent resective surgery.

Alpha-fetoprotein above normal levels as a risk factor for the development of hepatocellular carcinoma in patients infected with hepatitis C virus.

Background: Noninvasive risk factors are required for predicting the development of hepatocellular carcinoma (HCC) not only in patients with cirrhosis but also in those with chronic hepatitis who are infected with hepatitis C virus (HCV).

Methods: A total of 707 patients with chronic HCV infection without other risks were evaluated for the predictive value of noninvasive risk factors for HCC, including age, sex, viral load, genotype, fibrosis stage, aspartate and alanine aminotransferase levels, bilirubin, albumin, platelet count, and alpha-fetoprotein (AFP) at entry to the study, as well as interferon (IFN) therapy they received.

Results: The ten-year cumulative incidence rates of HCC for patients with fibrosis stages F0/F1, F2, F3, and F4 were 2.

A case of apoplectic lymphocytic hypophysitis complicated by polymyalgia rheumatica.

A case of apoplectic lymphocytic hypophysitis complicated by polymyalgia rheumatica (PMA) is described. A 72-year-old man was admitted to our hospital due to severe headache. Two months prior to admission, the patients had exhibited recent-onset stiffness and myalgia of shoulder and pelvic girdle that was compatible with PMR.

Serum amyloid A is a useful marker to evaluate the disease activity of Takayasu's arteritis.

Takayasu's arteritis (TA) is a rare large vessel vasculitis that is difficult to diagnose in the early stages. Therefore, it is also very difficult to manage and prevent irreversible vascular damage in TA. A 19-year-old female patient with back pain was examined using [(18)F]-FDG-PET to detect the source of inflammation.

[Pilomyxoid astrocytoma presenting in an elderly patient: a case report].

A 77-year-old man presented with progressive visual disturbance. MR images revealed a mass lesion mainly spreading in the left basal cistern, sylvian fissure and to the left hypothalamic region, with ventricular enlargement. To obtain precise diagnosis of the mass lesion, an open biopsy was performed.

Pneumatosis intestinalis in ulcerative colitis.

Background: UC patients are considered to be at risk for pneumatosis intestinalis (PI).

Case Report: A 50-year-old man who had been treated with prednisolone for left-sided ulcerative colitis (UC) underwent follow-up colonoscopy. In addition to active colitis in the left colon, some cystic lesions were found in the unaffected ascending colon.

Successful treatment of refractory cardiac tamponade due to rheumatoid arthritis using pericardial drainage.

Rheumatoid pericarditis occurs in patients with rheumatoid arthritis (RA). However, cardiac tamponade due to rheumatoid pericarditis is rare; we describe a case of a 72-year-old man with a 6-year history of rheumatoid arthritis who developed rheumatoid pericarditis with recurrent cardiac tamponade. The patient experienced relapse of the cardiac tamponade despite treatment with pericardiocentesis.

Complex wounds tend to develop more rapidly in patients receiving hemodialysis because of diabetes mellitus.

The number of patients requiring dialysis because of diabetes mellitus is increasing and such patients often have complex chronic wounds, which are difficult to heal. However, there are few retrospective studies of wounds requiring surgical treatment. We evaluated 14 patients receiving hemodialysis (HD) (8 because of diabetes and 6 because of other diseases) who had extremity wounds and underwent surgical treatment in our unit from 2004 through 2007.

Long-term trends of the incidence of hepatocellular carcinoma in the Nagasaki prefecture, Japan.

The incidence of hepatocellular carcinoma (HCC) in Japan is still increasing. The aim of the present study was to analyze the epidemiological trend of HCC in the Western area of Japan, Nagasaki. A total of 1,807 patients with HCC diagnosed at our two hospitals between 1981 and 2005 were consecutively recruited for this study.

Iliopsoas muscle abscess secondary to sacral pressure ulcer treated with computed tomography-guided aspiration and continuous irrigation: a case report.

Iliopsoas abscess is an aggressive infection usually associated with Crohn's disease, spinal tuberculosis, a septic hip joint (including hip replacement), and spinal cord injury. It rarely occurs secondary to sacral pressure ulcer. The infection requires immediate surgical debridement or drainage.