Leiomyosarcoma of the breast: a case report and review of the literature about therapeutic management.

We experienced a leiomyosarcoma of the breast in an 18-year-old female. No specific treatment has been established. In order to clarify appropriate therapeutic management methods, the limited data available from our and previous case reports were assessed.

[Anesthetic management of a hemodialysis-dependent patient implanted with a CRT-D device undergoing an operation for perforated peritonitis].

A 53-year-old man was admitted to our hospital for hematochezia, and an emergency operation was scheduled for his perforated sigmoid colon. He had received a CRT-D (cardiac resynchronization therapy with defibrillator) device for dilated cardiomyopathy two years before and had been receiving hemodialysis for the past year. Anesthesia was induced with midazolam and remifentanil and maintained with remifentanil and sevoflurane in oxygen.

Myelopathy hand: new evidence of the classical sign.

Study Design: Motion analysis on video files that captured grip and release cycles with fingers.

Objective: To reveal the kinematic characteristics of finger motion in cervical myelopathy.

Summary Of Background Data: Myelopathy patients are often unable to smoothly move their fingers in grip and release cycles.

Potential risk of thermal damage to cervical nerve roots by a high-speed drill.

Using the transverse processes of fresh porcine lumbar spines as an experimental model we evaluated the heat generated by a rotating burr of a high-speed drill in cutting the bone. The temperature at the drilled site reached 174 degrees C with a diamond burr and 77 degrees C with a steel burr. With water irrigation at a flow rate of 540 ml/hr an effective reduction in the temperature was achieved whereas irrigation with water at 180 ml/hr was much less effective.

Perioperative complications of primary posterior lumbar interbody fusion for nonisthmic spondylolisthesis: analysis of risk factors.

Object: Although posterior lumbar interbody fusion (PLIF) is an excellent procedure to attain circumferential decompression, it is technically demanding and can lead to various surgical complications. The authors retrospectively reviewed consecutive patients with nonisthmic spondylolisthesis who underwent PLIF to reveal the incidence and risk factors for perioperative complications of PLIF.

Methods: A total of 240 patients underwent PLIF.

Valvular injury in a patient with PR3-ANCA-associated glomerulonephritis.

Background An 11-year-old boy who had hematuria at a routine health check-up was later diagnosed with proteinase 3 (PR3) antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis. Despite treatment with corticosteroids and immunosuppressants, he went on to develop end-stage renal disease. The patient received a renal transplant at the age of 16 years, but relapse of PR3-ANCA-related nephritis to the graft occurred three times.

A simple performance test for quantifying the severity of cervical myelopathy.

We evaluated 30 patients with cervical myelopathy before and after decompressive surgery and compared them with 42 healthy controls. All were asked to grip and release their fingers as rapidly as possible for 15 seconds. Films recorded with a digital camera were divided into three files of five seconds each.

[Spontaneous mediastinal and retroperitoneal hematoma caused by trauma in an patient receiving anticoagulation treatment].

An 80-year-old man had chest and abdominal pains after he fell and twisted his body. He was taking anticoagulant drugs as a precautionary measure to prevent stroke. His chest CT and MRI was taking the presence of a sandglass-like nonenhanced shadow extending from the retromediastinum to the retroperitneum.

Dedifferentiated liposarcoma in the retroperitoneum in an atomic bomb survivor: report of a case.

A 76-year-old Japanese man was admitted to Kosei-Nenkin Hospital (Osaka, Japan) in November 2006; his chief complaint was a 10-kg loss in body weight over 3 months prior to admission. Abdominal computed tomography (CT) and dynamic magnetic resonance imaging (MRI) showed three masses in the retroperitoneum. The patient subsequently underwent surgery.

The source of axial pain after cervical laminoplasty-C7 is more crucial than deep extensor muscles.

Study Design: Prospective study to investigate the incidence of axial pain in the 3 different procedures of laminoplasty.

Objective: To inquire which is more important in the development of axial pain after laminoplasty: C7 or deep extensor muscles.

Summary Of Background Data: The etiology of axial pain remains largely unknown.

[Two cases of stage IV gastric cancer responding to chemotherapy with S-1 or UFT].

We report patients with advanced Stage IV gastric cancer responding to chemotherapy with S-1 or UFT. Case 1: The patient was a 59-year-old man with Stage IV gastric cancer because of CY 1. After surgery, chemotherapy with S-1 (100 mg/body/day) was performed for one year and 11 months.

[A case of stage IV gastric cancer treated sequentially for over two years by TS-1, paclitaxel, and CPT-11].

We report a patient with advanced stage IV gastric cancer treated by chemotherapy for over two years. The patient was a 69-year-old man with paraaortic lymph node metastasis of gastric cancer. He underwent a distal gastrectomy in non-curative resection.

Prediction of non-responsiveness to standard high-dose gamma-globulin therapy in patients with acute Kawasaki disease before starting initial treatment.

Clinical, laboratory, and echocardiographic data were retrospectively analyzed in 112 patients with acute Kawasaki disease who received high-dose (2 g/kg) intravenous gamma-globulin (IVIG) treatment within 2 days and were compared for those who were responsive and non-responsive to initial IVIG treatment. Coronary arteries adjusted for body surface area (BSA) were evaluated quantitatively by comparison with the mean dimensions for 85 normal control subjects. The incidence of coronary abnormalities was higher in IVIG-non-responsive patients as compared to IVIG-responsive patients (71% versus 5%, p<0.

Arthroscopic capsular release for painful throwing shoulder with posterior capsular tightness.

Posterior capsular tightness with glenohumeral internal rotation deficit is usually considered to be an acquired condition of the throwing shoulder and is usually treated conservatively. However, because posterior capsular tightness is sometimes irreversible, we have performed arthroscopic capsular release for painful throwing shoulder with posterior capsular tightness. The true loss of internal rotation and posterior stiffness was confirmed by examination with the patient under anesthesia, and contracture of the posterior capsule and the posterior band of the inferior glenohumeral ligamant was observed arthroscopically.

Large cell neuroendocrine thymic carcinoma coexisting within large WHO type AB thymoma.

Large cell neuroendocrine carcinoma (LCNEC) is a rare type of thymic epithelial tumor. It is recognized as a different entity from other thymic tumors on account of it having a more aggressive biologic behavior and poor prognosis. We report an extremely rare case of a very small, "large cell neuroendocrine thymic carcinoma" coexisting within a large thymoma that could not be detected by usual biopsy.

C3-6 laminoplasty takes over C3-7 laminoplasty with significantly lower incidence of axial neck pain.

Five-lamina (C3-7) procedure is the most popular cervical laminoplasty and there have been no studies on the most appropriate number of laminae to be opened. We prospectively reduced the range of laminoplasty from C3-7 to C3-6 in 2002 and compared the outcome of C3-6 laminoplasty (n=37) to that of C3-7 laminoplasty (n=28). In both groups, neurological gain was satisfactory, radiographic changes were minimal, and postoperative MRI indicated sufficient expansion of the dura and the spinal cord.

[Hyperparathyroidism in urology].

Primary hyperparathyroidism is one of the important endocrine disorders in urological field because it very often causes the recurrent urolithiasis. We experienced more than 800 cases of it since the middle of 20th century. We present the general aspect of primary hyperparathyroidism from the view point of urology.

Recurrent anterior shoulder dislocation caused by a midsubstance complete capsular tear.

Background: A midsubstance complete capsular tear is one of the well-known causes of anterior glenohumeral instability. However, its prevalence and clinical picture have not been well elucidated. The purpose of this study was to examine the prevalence of isolated complete capsular tears and to assess the clinical features as well as the results of surgical treatment of recurrent anterior glenohumeral instability caused by such tears.

[A case of complete atrioventricular block after induction of general anesthesia].

A 75-year-old man with a past history of bilateral thalamic hemorrhage was scheduled for cholecystectomy and cholelithotomy under general anesthesia. Although the preoperative ECG showed a complete right bundle branch block, the echocardiogram revealed no abnormality. Anesthesia was induced with thiopental and vecuronium, and maintained with sevoflurane in oxygen.

[A case of incomplete distal renal tubular acidosis undergoing repeated treatment by extracorporeal shock-wave lithotripay and transureteral lithotripsy for recurrent urolithiasis].

A 65-year-old woman was referred to our hospital for further examination of recurrent urinary stone formation. She had undergone 49 sessions of extracorporeal shock-wave lithotripay (ESWL) and 3 sessions of transureteral lithotripsy (TUL) under the diagnosis of idiopathic recurrent urolithiasis at another hospital. An excretory urography showed bilateral hydronephrosis and a retrograde urography revealed bilateral lower ureteral stricture.

[Diagnosis and treatment of differentiated thyroid carcinoma].

Thyroid cancer is the most common endocrine malignancy. More than 90% of primary thyroid cancers are differentiated papillary or follicular types. The prognosis for patients with differentiated thyroid carcinomas is favorable.

Videopericardioscopy using endothoracic sonography for lung cancer staging.

We performed videopericardioscopy using an endothoracic sonographic probe for the staging of left hilar nonsmall cell lung cancer. This method will be useful for an accurate diagnosis of direct tumor invasion into the intrapericardial great vessels and lead to the institution of appropriate treatment.

Tranexamic acid reduces postoperative blood loss in cementless total hip arthroplasty.

Background: Tranexamic acid, an inhibitor of fibrinolysis that blocks the lysine-binding site of plasminogen to fibrin, has been reported to reduce intraoperative and postoperative blood loss in patients undergoing total hip arthroplasty with cement. However, there have been few reports describing the effects of tranexamic acid on blood loss during and following total hip arthroplasty without cement.

Methods: We investigated the effects of tranexamic acid in twenty-one patients who underwent staged bilateral total hip arthroplasty without cement for the treatment of osteoarthritis of the hip.

Elimination of Pancoast tumor by carboplatin, paclitaxel, and concurrent radiation.

Preoperative chemoradiotherapy with carboplatin (AUC 1.5), paclitaxel (40 mg/m2), and concurrent extracorporeal radiation (40 Gy) was used to treat a Pancoast tumor (clinical T3N0M0), without causing adverse events. Then left upper lobectomy was performed along with mediastinal lymph node dissection plus resection of the chest wall and Th1 nerve root.