A case report: 201Tl/99mTc-Pyrophosphate dual-isotope myocardial SPECT for detecting annular subendocardial infarction induced by a transient shock.

The patient was a 74-year-old woman with angina pectoris, who had undergone percutaneous coronary intervention with stent placement in the right coronary artery on October 2, 2007. On November 12 of the same year, she suffered from paroxysmal atrial fibrillation. She was treated with pilsicainide hydrochloride administered by intravenous injection, which was followed by a sudden sinus standstill, with marked bradycardia and a shock state.

Pulmonary veno-occlusive disease in an 11-year-old girl: diagnostic pitfalls.

Pulmonary veno-occlusive disease (PVOD) is a rare chronic lung disease that is difficult to diagnose due to non-specific clinical findings. Little is known about the pathogenesis of PVOD. Reported herein is the case of an 11-year-old girl who initially presented with 'bat-wing' shadows on chest radiography.

Atropine eyedrops for death rattle in a terminal cancer patient.

"Death rattle" is a term used to describe the noisy sound produced by dying patients caused by the oscillatory movements of secretions in the upper airways. Antimuscarinic drugs, including atropine, scopolamine (hyoscine hydrobromide), hyoscine butylbromide, and glycopyrronium, have been used to diminish the noisy sound by reducing airway secretions. We report on the effectiveness of sublingual atropine eyedrops in alleviating death rattle in a terminal cancer patient.

Chlamydia pneumoniae infection-related hemophagocytic lymphohistiocytosis and acute encephalitis and poliomyelitis-like flaccid paralysis.

A 3-year-old male presented with Chlamydia pneumoniae infection-related hemophagocytic lymphohistiocytosis (HLH). The patient developed an episode of HLH with severe skin eruption following C. pneumoniae pneumonia.

The short-term outcome of the modified Sauvé-Kapandji procedure regarding range of motion, carpal bone translation and bony shelf size.

The Sauvé-Kapandji (S-K) procedure is a common treatment for rheumatoid wrists, but in some cases severe bone destruction makes this operative modality difficult to perform, while also resulting in a poor outcome. A modified S-K procedure for these wrists has been reported, but the clinical outcomes of the modified procedure are unclear. This study evaluated 24 wrists in 20 patients who underwent the modified S-K procedure.

Palmar petechiae (black spots on palms) in terminally ill patients with cancer: a sign of impending death.

Certain physical signs can be useful in predicting impending death. We present four terminally ill patients with malignancy who developed petechiae on their bilateral palms and fingers during the week prior to their deaths. Drug-induced eruption, injury, and mechanical stimuli were thought to be unlikely causes of the petechiae.

[Application of continuous controlled administration of three agents for total intravenous anesthesia].

General anesthesia was maintained by continuous administration of propofol, rocuronium and remifentanil. The dose of the medicine was determined by the effect site concentration calculated on a pharmacokinetics simulator respectively. Furthermore, a pharmacokinetics simulator enabled us to predict duration before the appearance of awareness.

[A case of S-1-resistant gastric cancer with multiple bone metastases and disseminated intravascular coagulation--effective treatment by combined chemotherapy with CDDP and CPT-11].

A 49-year-old female with advanced gastric cancer complicated with peritoneal dissemination underwent distal gastrectomy, and thereafter she was treated with a combined chemotherapy of S-1 and paclitaxel for 5 months, followed by treatment with S-1 alone. A year after the gastrectomy, she developed disseminated intravascular coagulation (DIC) with multiple bone metastases despite the continuous treatment with S-1, indicating that S-1 was no longer effective. She was then effectively treated by a combined chemotherapy with cisplatin(CDDP)and irinotecan hydrochloride (CPT-11), and DIC subsided within 7 days after the treatment.

[Small cell lung cancer complicated by opsoclonus myoclonus syndrome].

Opsoclonus myoclonus syndrome, one of the paraneoplastic neurological syndromes involving several neurological symptoms that result from "remote effects" of cancer, is a rare disease characterized by opsoclonus, cerebellar ataxia and myoclonus of the trunk and extremities. A 53-year-old man was admitted with dizziness and difficulty walking. Medical examinations led to a diagnosis of opsoclonus myoclonus syndrome.

Care for imminently dying cancer patients: family members' experiences and recommendations.

PURPOSE The aim of this study was to clarify the level of emotional distress experienced by bereaved family members and the perceived necessity for improvement in the care for imminently dying patients and to explore possible causes of distress and alleviating measures. METHODS A cross-sectional nationwide survey was performed in 2007 of bereaved families of cancer patients at 95 palliative care units across Japan. Results Questionnaires were sent to 670 families, and 76% responded.

Care for the bodies of deceased cancer inpatients in Japanese palliative care units.

Objectives: The aim of this study is to clarify the actual experiences and preferences of the bereaved family for the care of their deceased family member.

Methods: At 95 palliative care units in Japan, a cross-sectional nationwide survey of the bereaved families of cancer patients was performed in 2007.

Results: Of the 670 questionnaires sent to bereaved families, 492 were returned (response rate of 76%).

Treatment of malignant enterovesical fistula with octreotide.

Surgical treatment for internal fistula is rarely indicated for terminally ill patients with cancer because of their poor prognoses. Reports of surgical or pharmacologic treatment of vesicoenteric fistula in terminally ill patients with cancer are rare. A 73-year-old woman with rectal cancer that had directly invaded the bladder and metastasized to the liver was admitted to our hospital with high fever and severe perineal pain.

Radiological imaging change in a malignant bowel obstruction patient treated with octreotide.

Introduction: Malignant bowel obstruction (MBO) is a complication in advanced cancer patients with abdominal and pelvic malignancy. Recent research has established the efficacy of octreotide for MBO-related symptom relief. The mechanism that octreotide increases water absorption in case of MBO has not been demonstrated except for experimental animal and normal human model.

[Gabapentin mitigates neuropathic pain in cancer patients--a case report].

A 64-year-old male underwent low anterior resection of the rectum for rectal cancer. Five years later, he suffered neuropathic cancer pain on the left-posterior surface of his thigh caused by sacral invasion of the recurrence site. His neuropathic pain was not sufficiently responsive to the combination therapy of opioids, non-steroidal antiinflammatory drugs (NSAIDs), continuous infusion of subcutaneous ketamine and oral mexiletine.

[Efficacy of controlled-release oxycodone for dyspnea in cancer patients--three case series].

Dyspnea is a common symptom in patients with advanced cancer. Systemic morphine administration has been reported as an effective pharmacological treatment to control dyspnea. However, there have been few reports on similar effects of alternative opioids except for morphine.

[Olanzapine use in cancer patients for refractory vomiting].

Recent investigations suggest the efficacy of olanzapine in cancer patients with intractable vomiting or chemotherapy-induced nausea. Olanzapine,indicated for schizophrenia in Japan, has an affinity for multiple neurotransmitter receptors including dopaminergic, serotonergic, histaminergic, adrenergic and muscarinic receptors. This pharmacological activity thus has a potential role in the treatment of nausea and vomiting.

[The opioid combination of transdermal fentanyl and sustained release morphine for refractory cancer pain--a case report].

Transdermal fentanyl (TDF) has been increasingly administered for the management of cancer pain. Occasionally, some patients fail to obtain poor analgesic effects with its dose escalation. We discuss a case of a 44-year-old male diagnosed with lung cancer with back pain caused by bone metastasis.

Endovascular treatment of vertebral artery aneurysm manifesting as progressive hemifacial spasm.

A 62-year-old woman presented with right hemifacial spasm persisting for 6 months. Brain magnetic resonance imaging and digital subtraction angiography showed a wide-neck aneurysm of the intracranial portion of the right vertebral artery. The patient underwent endovascular trapping of the aneurysm by coil embolization of the parent vessel on both sides of the aneurysm.

[Detection of deep vein thrombosis in preoperative patients using venous ultrasonography].

Background: Using Doppler ultrasonography (US), deep vein thrombosis (DVT) has been detected in the lower limbs of preoperative patients.

Methods: Of 1,087 patients scheduled for surgery from January to June 2002, US was performed in 85 patients with a history of thromboembolism, a presence of abnormality in the lower extremities, or prolonged bed rest.

Results: In five patients thrombi were detected by US, but not in patients with a history of thromboembolism.

Case of acute ileus caused by a spirurina larva.

A growing body of clinical cases suggests that a kind of nematode larva, type X larva of the suborder Spirurina that inhabits firefly squids (Watasenia scintillans, or 'Hotaru-ika' in Japanese), can cause acute ileus in humans. However, the larva itself has rarely been found in the wall of the obstructed intestine. We describe here a case of acute ileus, in which a type X spirurina larva was found histologically.

Management of oral leukoplakia by laser surgery: relation between recurrence and malignant transformation and clinicopathological features.

Objective: The aim of the present study was to assess the clinical usefulness of laser surgery for oral leukoplakia.

Background: Recurrence and/or malignanT transformation of oral leukoplakia have occasionally been observed following laser surgery. It is reported that the rate of recurrence was 7.

Doubling time of serum CA 19-9 in the clinical course of patients with pancreatic cancer and its significant association with prognosis.

Background And Objectives: Pancreatic cancer is generally a disease with a poor prognosis, and relationship between change of serum CA 19-9 level and progression of this disease was investigated with regard to clinical pace of disease and tumor growth.

Methods: CA 19-9 doubling time was examined in 75 patients with pancreatic cancer, including 41 inoperable cases. Then, its relation with their prognosis and change in tumor was evaluated.