[Resection of a synchronous liver metastasis from gastric cancer associated with portal vein tumor thrombosis - a case report].

The patient was a 71-year-old woman who was referred to our hospital with a diagnosis of gastric cancer. Computed tomography( CT) scans revealed a liver tumor, which we diagnosed as liver metastasis from the gastric cancer. A type 2 tumor was observed in the lesser curvature side of the gastric angle, and a huge tumor measuring 75 mm was seen in the lateral segment of the liver.

Characteristics of the small bowel lesions detected by capsule endoscopy in patients with chronic kidney disease.

Obscure gastrointestinal bleeding (OGIB) is one of the common complications in patients with chronic kidney disease (CKD), especially those who are on maintenance hemodialysis (HD). However, little is known about the characteristics of the small-bowel lesions in these patients, or of the factors that could predict the presence of such lesions. Therefore we enrolled a total of 42 CKD patients (including 19 HD patients and 23 non-HD patients), and compared the incidence of the small-bowel lesions among two groups.

Urine screening for patients with developmental disabilities detected a patient with creatine transporter deficiency due to a novel missense mutation in SLC6A8.

Creatine transporter deficiency (CTD) is an example of X-linked intellectual disability syndromes, caused by mutations in SLC6A8 on Xq28. Although this is the second most frequent genetic cause of intellectual disabilities in Europe or America after Fragile X syndrome, information on the morbidity of this disease is limited in Japan. Using the HPLC screening method we have established recently, we examined samples of urine of 105 patients (73 males and 32 females) with developmental disabilities at our medical center.

[A case of diffuse hepatocellular carcinoma(Vp4) treated by right hepatic trisegmentectomy and multidisciplinary therapy regimens].

A 59-year-old woman was admitted to our hospital for treatment of a right humerus fracture. The patient was diagnosed with hepatocellular carcinoma during work-up for hepatic dysfunction. A diffusely spreading tumor was observed from the right lobe to the medial segment of the liver, and a portal vein tumor thrombus filled the right branch of the portal vein and extended into the main trunk, accompanied by cavernous transformation (Vp4).

[A case of long-term survival of a patient with intrahepatic bile duct cancer and early nodal recurrence who responded to S-1 therapy].

A 71-year-old man was referred to our hospital for further evaluation of hepatic dysfunction. A diagnostic workup revealed an intrahepatic bile duct cancer, and a right hepatic lobectomy was performed. Postoperative adjuvant chemotherapy with gemcitabine (1,000 mg/m², given for 3 weeks, followed by a 1 week rest) was begun.

[A long-term survivor who received S-1-based multidisciplinary therapy for unresectable advanced pancreatic cancer].

A 62-year-old woman with a diagnosis of pancreatic cancer with splenic invasion, liver metastasis, and peritoneal dissemination was scheduled to receive chemotherapy. However, emergency surgery was performed because of an exacerbation of ileus. Laparotomy revealed moderate ascites and innumerable nodular lesions on the mesenteric side of the small intestine and colon.

[Anesthetic management in a patient with trifunctional protein deficiency].

A 4-year-old girl with trifunctional protein deficiency was scheduled for gastrostomy. She had recurrent episodes of rhabdomyolysis triggered by fasting, infection, stress and uncertain causes. In the management of anesthesia, we avoided both propofol and inhalational anesthetics and anesthetized her with benzodiazepine and opioid combined with regional anesthesia to minimize the stress response.

[A case of unresectable advanced gallbladder cancer successfully treated by a combined administration of gemcitabine + CDDP].

The patient, a 54-year-old male, reported to our hospital with major complaints of epigastric pain and brownish coloration of the urine. His history included resections of the left kidney and ureter due to a cancer of the left renal pelvis. The diagnosis was gallbladder cancer with infiltration of the liver and mesoduodenal ligament and lymphatic metastasis.

[The effectiveness of reduction surgery and gemcitabine for multiple bowel obstructions due to peritoneal dissemination of pancreatic carcinoma with liver metastasis--a case report].

A 62-year-old woman visited our hospital because of the increasing lower left abdominal distention. Computed tomography (CT) revealed pancreatic carcinoma invading to spleen with liver metastasis and peritoneal dissemination. Soon after, the patient showed a severe bowel obstruction symptom, so we performed an emergency operation.

[A case of advanced rectal carcinoma with multiple lung metastases responding to irinotecan combined with 5-fluorouracil and l-leucovorin (IFL) as neoadjuvant chemotherapy (NAC)].

A 53-year-old man, admitted for inguinal hernia, complained of body weight loss in a preoperative condition check. We examined the digestive tract and diagnosed stage IV advanced rectal carcinoma with multiple lung metastases. It caused ileus, so emergency colostomy was performed.

Acute scrotum caused by Henoch-Schönlein purpura.

A boy aged 3 years and 11 months with arthralgia and purpuric skin rash was diagnosed with Henoch-Schönlein purpura (HSP) following an acute occurrence of his scrotal pain and swelling 17 days after the appearance of arthralgia. Immediate scrotal exploration was performed to confirm vasculitis of the left epididymis compatible with a scrotal manifestation of HSP. Postoperative course was uneventful.

[Anesthetic management of a patient with severe hyponatremia].

A 62-year-old woman was scheduled for an operation for ileus. Before the operation, we noticed severe hyponatremia (Na 117 mEq x l(-1)) probably due to dehydration. We corrected her hyponatremia slowly to avoid central pontine myelinolysis.

[A case of metastatic Enterococcus faecalis endophthalmitis].

We reported a case of successful treatment of early-stage metastatic endophthalmitis caused by Enterococcus faecalis with vitrectomy and lensectomy. The case was a 50-year-old male with poorly controlled diabetes. Following T-tube drainage for a necrotic cholecystitis operation, he developed iridocyclitis in both eyes as well as fever.

[Posterior fossa hemorrhage 11 years after the use of silastic dural substitute: case report].

A case of posterior fossa hemorrhage is reported. The hemorrhage occurred 11 years after posterior fossa craniotomy with closure using a graft of silastic dural substitute. This 14 year-old girl underwent suboccipital craniotomy at the age of 3 years because of traumatic posterior fossa hemorrhage.