Severe insulin allergy successfully treated with continuous subcutaneous insulin infusion.

Insulin allergy is a rare complication of insulin therapy. Proper management, though difficult, is critical. Here, we report the case of a patient with type 2 diabetes and insulin allergy, successfully treated with continuous subcutaneous insulin infusion (CSII).

[Lumbar radiculopathy presenting neuralgic amyotrophy with gadolinium-enhanced MRI lesions: a case report].

A 40-year-old man presented with sudden onset of severe left buttock pain that radiated down the thigh to the leg. On examination, he showed moderate weakness and atrophy in the left quadriceps and tibialis anterior muscles, and absence of a left patellar tendon reflex. Needle electromyography revealed an active denervation pattern in the left quadriceps muscles, suggesting neuralgic amyotrophy.

Non-operative treated spontaneous spinal epidural hematoma in a 12-year-old boy.

Spontaneous spinal epidural hematoma (SSEH) has been reported as a rare condition especially in childhood. Because its symptoms are atypical, it is not easy to diagnose the onset of SSEH. However, with wider use of magnetic resonance imaging (MRI), several SSEH cases, especially not requiring surgical intervention, have been reported.

Anti-aquaporin-4 antibody-positive neuromyelitis optica presenting with syndrome of inappropriate antidiuretic hormone secretion as an initial manifestation.

The distribution of neuromyelitis optica (NMO)-characteristic brain lesions corresponds to sites of high aquaporin-4 (AQP4) expression, and the brainstem and hypothalamus lesions that express high levels of AQP4 protein are relatively characteristic of NMO. The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is one of the important causes of hyponatremia and results from an abnormal production or sustained secretion of antidiuretic hormone (ADH). SIADH has been associated with many clinical states or syndromes, and the hypothalamic-neurohypophyseal system regulates the feedback control system for ADH secretion.

Effect of distal radius volar plate position on contact pressure between the flexor pollicis longus tendon and the distal plate edge.

Purpose: Some clinical studies have suggested that distal radius plates placed distal to the watershed line have the potential to impinge on the traversing flexor tendons. However, the validity of this theory remains unclear. The purpose of this study was to evaluate the quantitative effect of volar plate position on flexor pollicis longus (FPL) tendon friction by measuring the contact pressure between the FPL tendon and the distal edge of the locking plate.

[A case of clinically mild encephalitis/encephalopathy with a reversible splenial lesion associated with anti-glutamate receptor antibody].

We report the case of an 18-year-old boy who presented with disturbance of consciousness and generalized seizures following flu-like symptoms such as high fever and arthralgia. T2 and diffusion weighted brain magnetic resonance images showed a hyperintense ovoid lesion in the splenium of the corpus callosum and T, weighted images showed a hypointense lesion; the lesion completely disappeared on repeat imaging after 3 days. Antiglutamate epsilon2 receptor antibodies were detected in his cerebrospinal fluid.

[Case of incomplete brown-Séquard syndrome after thoracic herpes zoster infection].

e report an 87-year-old woman who presented with incomplete Brown-Séquard syndrome after reactivation of varicella-zoster virus (VZV). Two days after herpes zoster in the right side of the chest, she developed weakness of the right lower limb. Neurological examination revealed a spastic palsy in the right lower limb and left side loss of pain and temperature sense to T6.

[Neuromyelitis optica in a patient with Sjögren syndrome with distal renal tubular acidosis: case report].

We report the case of a 31-year-old woman who presented with neuromyelitis optica (NMO) associated with Sjögren syndrome and distal renal tubular acidosis. She was hospitalized because of cervical transverse myelopathy and right optic neuritis. She had been clinically diagnosed with Sj6gren syndrome, with a high titer of anti-SS-A antibody (1:500) and anti-SS-B antibody (1:498).

Four cases of arthritis associated with Mycoplasma pneumoniae infection.

Background: Mycoplasma pneumoniae infection is diagnosed commonly by marked elevation of serum antibodies, but this requires several days and consequently M. pneumoniae infection might be overlooked in some cases. Recently an ImmunoCard Mycoplasma rapid diagnosis test (IC) has been developed and used clinically.

Intracerebral hemorrhage associated with livedo racemosa.

We report on a case of intracerebral hemorrhage associated with livedo racemosa in a 13-year-old girl. A skin biopsy specimen showed endothelitis and mixed inflammatory cellular infiltrate around the small arteries. We believe that the cerebral hemorrhage might have been caused by fragility of the intracranial small arteries and that this case could be an example of an early stage of Sneddon's syndrome.

[Three cases of de novo aneurysms].

We report 3 cases of de novo aneurysms that developed long after neck clipping of the initial aneurysms (range, 7 to 20 years, mean 12 years). Case 1 was a 58-year-old female who had undergone clipping of a ruptured aneurysm 17 years previously. Ten years later, she suffered another subarachnoid hemorrhage due to rupture of a new aneurysm, for which neck clipping was performed.

Bilateral discoid medial menisci accompanied by distal arthrogryposis: a case report.

Discoid meniscus shows a propensity for the lateral side, and bilateral discoid medial meniscus is extremely rare. The present patient had a history of windblown hand and clubfoot, and bilateral discoid medial meniscus was associated with distal arthrogryposis. There has been no previous case report about the coexistence of meniscal abnormalities and distal arthrogryposis.

Antiplatelet therapy and spontaneous perirenal hematoma.

This case report clarifies an adverse reaction of antiplatelet therapy which has been a standard prophylactic method for patients harboring significant risks of thromboembolic events. A 71-year-old Japanese man who had been taking aspirin tablets (81 mg) for a year presented with sudden colic pain in the left flank region. An abdominal computed tomography scan revealed a significant perirenal hematoma of the left kidney.

[External fixation for the fracture repair].

External fixation has made remarkable progress in the field of orthopaedic surgery in recent years. The concept of distraction histogenesis made it possible to treat for the difficult case without bone graft, such as shortening and deformities of the limbs, pseudarthrosis, bone loss and osteomyelitis etc. These advances have led to the cure of many unsolved fractures.

[Prevalence and risk factors for latex sensitization among anesthesiologists].

Background: Although powdered latex surgical gloves are predominantly used in Japanese healthcare facilities, the prevalence of latex sensitization among anesthesiologists has not been investigated.

Methods: The authors surveyed 60 anesthesiologists of 16 facilities with questionnaires and measurements of specific IgE antibodies against latex and other aeroallergens by AlaSTAT microplate immunoassay. Sensitization was defined as positive if the specific IgE concentration was not less than 0.

Intravenous administration of flurbiprofen does not affect cerebral blood flow velocity and cerebral oxygenation under isoflurane and propofol anesthesia.

Unlabelled: Flurbiprofen, a nonsteroidal antiinflammatory drug (NSAID), has been used to treat rheumatic and osteoarthritic pain and to reduce postoperative pain. Although other NSAIDs, such as indomethacin, reduce cerebral blood flow (CBF), the effect of flurbiprofen on CBF is unknown. In the present study, we investigated the effects of flurbiprofen on cerebral blood flow velocity (CBFV) and cerebral oxygenation under isoflurane or propofol anesthesia.

Indication and practice of reverse flow extensor digitorum brevis muscle flap transfer.

Although the pedicled extensor digitorum brevis (EDB) muscle flap is a versatile flap, there are not many reports about it. Furthermore, there are few reports about the reverse vascular flow EDB muscle flap. The lateral tarsal artery coming from the dorsalis pedis artery nourishes the EDB muscle flap.

[Successful TS-1 therapy in a patient with non-resectable gastric cancer and renal dysfunction].

A 73-year-old woman presented to our hospital with epigastric pain and swelling of the left upper limb. Enlarged lymph nodes with adhesion were palpable in the left cervical region and supraclavicular fossa. Tests were performed with the thought that the left upper limb swelling was secondary to venous compression by the enlarged lymph nodes.

[A case of sphenoid sinus mucocele].

Infection of the sphenoid sinus is an uncommon clinical entity frequently misdiagnosed because of its vague symptoms and paucity of clinical findings. We report a case of sphenoid sinus mucocele complicated by retro-orbital pain and ipsilateral optic atrophy. CT scan and MR image revealed a cystic mass lesion of the sphenoid sinus.

[Vitamin deficiencies and hypervitaminosis].

There have recently been very few deficiencies with respect to fat soluble and water soluble vitamins in Japan All-trans-retinoic acid as induction or maintenance treatment improves disease free and overall survival against acute promyelocytic leukemia. In the isolated vitamin E deficiencies gene mutation has been cleared for alpha-tocopherol transferprotein. Recently, a relation of nutritional vitamin K intake and senile osteoporosis in women was epidemiologically demonstrated on a prospective study.

Intrameatal aneurysm successfully treated by meatal loop trapping--case report.

A 77-year-old female presented with a rare intrameatal aneurysm manifesting as sudden onset of headache, hearing loss, tinnitus, and vertigo associated with subarachnoid hemorrhage. Meatal loop trapping was performed. After surgery, the patient's functions recovered almost completely, probably because of the preservation of the 7th and 8th cranial nerves and the presence of effective collaterals in the area supplied by the anterior inferior cerebellar artery.

[Severe stenosis of the internal carotid artery and intracerebral hematoma associated with neurofibromatosis type 1: a case report].

Neurofibromatosis Type 1 produces a broad spectrum of clinical manifestations as a result of widespread dysplasia of mesodermal and neuroectodermal tissues. One of the most serious aspects of the disease relates to the arterial involvement that may occur. We report a case of severe stenosis of the internal carotid artery and intracerebral hemorrhage associated with neurofibromatosis Type 1.