[Inguinal lymph node metastasis of bladder carcinoma ten years after cystourethrectomy: a case report].

A 79-year-old man had undergone radical cystourethrectomy for bladder carcinoma in January, 1989. Pathological report was Small cell carcinoma (SCC) >> transitional cell carcinoma (TCC), G2 > G3, pT4 (prostate), ew (-). Ten years later, follow-up computed tomography (CT) revealed swollen left inguinal lymph node in October 1998 and lymph node dissection was performed in January, 2000.

[A case of an increase in resectability with preoperative chemotherapy TS-1 combined with CPT-11 for unresectable rectal cancer in downstaging].

A 50-year-old woman visited our hospital with a chief complaint of lower abdominal mass. The patient was diagnosed with rectal cancer using colonoscopy and also diagnosed with unresectable rectal cancer because abdominal CT revealed metastases to the liver, lung and lymph node located porta hepatis. The patient was treated with TS-1 combined with CPT-11.

Computed tomographic scanning and selective laparoscopy in the diagnosis of blunt bowel injury: a prospective study.

Background: We prospectively evaluated whether computed tomographic (CT) scanning and selective laparoscopy (LP) for the diagnosis of blunt bowel injury (BBI) could prevent nontherapeutic laparotomy and delayed diagnosis.

Methods: Between April 1994 and May 2002, hemodynamically stable patients suspected of having BBI were enrolled in this study. Patients with hemodynamic instability or solid organ injuries with hemoperitoneum were excluded.

[Retrograde nasal intubation for a patient with difficult airway by using 28 Fr double lumen tube].

We experienced retrograde nasal intubation with a 28 Fr double lumen tube (DLT) in a patient with difficult airway. A 56-year-old man who had undergone an operation for carcinoma of the floor of the mouth was scheduled for right upper lobectomy with video-assisted thoracic surgery. Because of the postoperative anatomical anomaly, the usual laryngoscopy and retrograde oral intubation was not successful.

[Bladder carcinoma metastases presenting as intraperitoneal dissemination without local recurrence: a case report].

A 76-year-old woman presented with gross hematuria and was referred to our OPD. Cystoscopy showed broad-based papillary tumors on the left bladder wall. TUR-BT was performed and pathological diagnosis was grade 3 transitional cell carcinoma of pT1a.

[Evaluation of 115 consecutive patients with blunt renal trauma by using the classification for renal injury of Japanese Association for the Surgery of Trauma].

Objective: To evaluate the clinical usefulness of the classification for renal injury, proposed by Japanese Association for the Surgery of Trauma (JAST).

Method: JAST classification for renal injuries consists of categories as: Type I (subcapsular injury); Type II (superficial injury); type III (deep injury); type IV (pedicle injury). Type III injuries are subclassified into: IIIa (deep laceration); IIIb (transection); IIIc (fragmentation).

Reevaluation of ultrasonography for solid-organ injury in blunt abdominal trauma.

Objective: To reevaluate the usefulness of ultrasonography for detecting and classifying solid-organ injuries from blunt abdominal trauma by comparing ultrasonography with computed tomography (CT) and laparotomy.

Methods: Six hundred four patients with blunt abdominal trauma were examined by both B-mode ultrasonography and CT for a study period of 14 years. The ultrasonographic examiners were divided into 2 groups depending on their experience with ultrasonography.

[A case of unresectable pancreatic cancer showing tumor dormancy treated with gemcitabine].

A 67-year-old woman visited our hospital with a chief complaint of epigastralgia. The patient was diagnosed as having unresectable pancreatic cancer because abdominal CT and angiography revealed a tumor that had invaded a common bile duct, portal vein and superior mesenteric vein. A palliative operation was performed because of obstructive jaundice.

Irreducible lateral dislocation of the proximal interphalangeal joint--a case report.

We present a rare case of a lateral dislocation of the proximal interphalangeal joint that required open reduction. During an operation, we found the collateral ligament and the capsule interposing into the joint space. After reducing the soft tissue and reproducing the collateral ligament with a suture anchor, sufficient joint stability and full range of motion was achieved.

Povidone-iodine ointment and gauze dressings associated with reduced catheter-related infection in seriously ill neurosurgical patients.

Povidone-iodine ointment and gauze covered by transparent dressings were compared with transparent dressings alone in historical controls (both changed twice weekly) in neurosurgical patients needing catheter placement for prolonged periods. Colonization and bloodstream infection were both reduced with the new method (P < .01 and P = .

[A case of advanced gastric cancer that had invaded the duodenum treated with combined chemotherapy using TS-1 and low-dose CDDP, which prevented the need for a pancreaticoduodenectomy].

A 59-year-old woman visited our hospital with a chief complaint of body weight loss and abdominal distension. Gastrofiberscopy revealed a gastric tumor that had invaded the duodenum of the second portion. The patient was treated with combined chemotherapy using TS-1 and CDDP, as it was deemed necessary to perform a pancreaticoduodenectomy for surgical curative resection.

Spontaneous resolution of nontraumatic bilateral intracranial vertebral artery dissections.

A 49-year-old man presented with nontraumatic bilateral intracranial vertebral artery dissections without subarachnoid hemorrhage manifesting as Wallenberg's syndrome on the right. Magnetic resonance imaging revealed an infarct in the right dorsolateral aspect of the medulla oblongata. Antiplatelet therapy was administered.

[Renal cell carcinoma metastatic to the ovary: a case report].

A 47-year-old woman underwent left radical nephrectomy in 1995, and pathological diagnosis showed a primary renal cell carcinoma with clear cell subtype. Four years later on her routine checkup, abdominal computerized tomography revealed a 9-cm of predominantly solid and partially cystic tumor in the pelvic cavity. The patient was referred to Gynecologic Department and a total hysterectomy with bilateral salpingo-oophorectomy was subsequently performed under the diagnosis of a left ovarian tumor.

An outbreak of allergy-like food poisoning.

Eight cases of allergy-like food poisoning resulting from the ingestion of yellowfin tuna, which had been kept in stock for 10 days prior to being cooked, are described. The main symptoms were headaches, facial flushing and palpitation. Samples of the ingested fish were analyzed for histamine content, and a high level of histamine was confirmed (310 mg/100 g of fish).

[A case of acute pulmonary embolism associated with squatting].

The patient was a 69-year-old man with a 3-year history of diabetes mellitus accompanied by cerebral infarction and arteriosclerosis obliterans of the lower extremities. After squatting to clean a car, the patient began to experience dyspnea. A blood gas analysis was performed upon admission, and the patient's PaCO2 and PaO2 levels were found to be low.

Cavernous angioma of the corpus callosum mimicking an astrocytic tumor--case report.

A 49-year-old female presented with a mass at the genu of corpus callosum manifesting as vertiginous sensation persisting for a couple of months. The preoperative diagnosis based on neuroimaging was astrocytic tumor, probably an oligodendroglioma. The mass was totally excised through a left interhemispheric approach without postoperative neurological deficits.

Hyponatremia with increased plasma antidiuretic hormone in a case of hypothyroidism.

We report a 70-year-old woman with hypothyroidism and severe hyponatremia. Her plasma antidiuretic hormone (ADH) level was inappropriately high for her low plasma osmolality. Her low serum sodium level was gradually corrected by water restriction and sodium supplementation prior to the initiation of thyroid hormone replacement.

[A case of Klebsiella pneumoniae infection causing a buccal abscess complicated with multiple lung abscesses].

A 51 year-old man fitted with a dental prosthesis was hospitalized with buccal swelling, fever and chest pain. Laboratory data showed marked inflammatory changes, and chest radiography and CT scanning revealed small nodular shadows within the lung. A diagnosis of multiple lung abscesses secondary to a buccal abscess possibly caused by the prosthesis was made from needle aspiration biopsies of the lung nodules and of a buccal lesion.

[A case of non-small-cell lung cancer successfully treated using combination chemotherapy with CDDP and vinorelbine].

A 67-year-old woman presented to our hospital with a chief complaint of bloody sputum. A plain chest X-ray a CT scan revealed a tumor shadow 3 cm in size in the middle lobe of the right lung, multiple nodular shadows in the bilateral lung fields and enlarged hilar and mediastinal lymph nodes. A tumor biopsy done under bronchoscopy revealed poorly differentiated adenocarcinoma of the lungs (cT2N3M1).

Treatment of mallet fractures using compression fixation pins.

Fifteen patients who underwent percutaneous fixation of mallet fractures of the distal phalanx using compression fixation pins were assessed. Anatomical reduction was achieved in all patients. There were no nonunions.

Thoracoscopic resection of the lung with the ultrasonic scalpel.

We used an ultrasonic scalpel, the Harmonic Scalpel (Ethicon Endo-Surgery, Cincinnati, OH), for limited thoracoscopic resection of the lung in 30 consecutive patients. There were no problems with bleeding in any of the 30 patients. After resection with Harmonic Scalpel the lung was closed with absorbable sutures.

Development of primary leiomyosarcoma of the sternum postirradiation: report of a case.

We report herein the case of a 30-year-old man who developed a primary leiomyosarcoma (LMS) 11 years after undergoing a median sternotomy for mediastinal seminoma followed by 50 Gy radiotherapy. He was given two courses of chemotherapy, resulting in 90% tumor regression, after which resection of the tumor with adjacent chest wall structures was carried out. Reconstruction was performed using a methylmethacrylate prosthesis prepared preoperatively.

Usefulness and limitations of ultrasonography in the initial evaluation of blunt abdominal trauma.

Background: In the assessment of blunt abdominal trauma, the reliability of ultrasonography (US) in identifying individual organ injuries remains uncertain, in spite of its usefulness in detecting hemoperitoneum. This study was designed to evaluate the overall diagnostic value of US, including identification of individual organ injuries.

Methods: The accuracy of US in the detection of intra-abdominal injuries and the identification of individual organ injuries was evaluated in 1,239 patients seen during a 15-year period.

Segmental bioelectrical impedance analysis improves the prediction for extracellular water volume changes during abdominal surgery.

Objective: To determine whether the segmental multifrequency bioelectrical impedance analysis may improve the prediction for intraoperative changes in extracellular water volume (deltaECW) compared with whole body multifrequency bioelectrical impedance analysis in abdominal surgical patients.

Design: Prospective, consecutive sample.

Setting: Surgical operative patients in a university-affiliated city hospital.