Successful treatment of intravascular large B-cell lymphoma diagnosed by bone marrow biopsy and FDG-PET scan.

Early diagnosis of intravascular large B-cell lymphoma (IVLBCL) is difficult, but is critical for longer survival for the patients. We report a case of IVLBCL that was diagnosed with the help of FDG-PET. A 76-year-old woman was referred to us for the evaluation of her elevated serum LDH.

Ritodrine pharmacokinetics in twin pregnancy patients.

Objectives: To establish a rational ritodrine therapy in relation to serum ritodrine concentration, we examined 14 twin pregnancy patients and determined their pharmacokinetic data.

Methods: We measured serum concentrations of ritodrine in twin pregnancy patients using high-performance liquid chromatography (HPLC).

Results: The twin pregnancy patients all exhibited linear ritodrine pharmacokinetic profiles.

Correlation between salivary alpha-amylase activity and pain scale in patients with chronic pain.

Background And Objectives: The visual analog scale (VAS) is commonly used to assess pain intensity. However, the VAS is of limited value if patients fail to reliably report. Objective assessments are therefore clearly preferable.

[Eosinophilic airway disorders: important causes of prolonged cough in Japan].

We studied 223 outpatients who presented between October 2001 and June 2003 with persistent cough of more than 3 weeks' duration. Eosinophilic airway disorders (EAD), including atopic cough and cough variant asthma, were clinically diagnosed in 119 patients, on the basis of the following factors: history of atopic disease, duration of cough, history of previous prolonged cough, or presence of forced expiration wheeze. Since eosinophils are frequently found in the sputum of patients with EAD, a positive test strongly suggests the presence of EAD.

A1166C variant of angiotensin II type 1 receptor gene is associated with severe hypertension in pregnancy independently of T235 variant of angiotensinogen gene.

Hypertension in pregnancy (HP) is a multifactorial disease manifested due to a complex combination of environmental factors and several predisposing genes including factors in the renin angiotensin system. The aim of this study was to assess the association between the A1166C variant of the angiotensin II type 1 receptor (AT1) gene and severe HP. We carried out association studies and multivariate analyses including other candidate causal factors of HP such as the M235T variant of the angiotensinogen (AGT) gene, prepregnancy body mass index (BMI), and family history of hypertension in Japanese subjects.

Characteristics of postictal headache in patients with partial epilepsy.

Migraine-like features sometimes characterize the headache that follows epileptic seizure (postictal headache, PIH). We compared patients with different types of epilepsy to investigate the association between migraine-like PIH and seizure type. Subjects comprised 364 patients with partial epilepsy.

Multi-center study on post-ictal headache in patients with localization-related epilepsy.

The nature of post-ictal headache (PIH) remains unclear. A multicenter study was conducted in order to evaluate frequency and risk factors for PIH. The subjects consisted of 97 patients with temporal lobe epilepsy (TLE), 65 patients with frontal lobe epilepsy (FLE) and 37 patients with occipital lobe epilepsy (OLE).

[Leukemic meningitis in B-cell prolymphocytic leukemia].

An 84-year-old woman was admitted because of anemia and marked leukocytosis. The white cell count was 237,660/microliter, with 93% abnormal lymphoid cells. The cells had abundant cytoplasm and prominent nucleoli.

De novo CD5-positive diffuse large B cell lymphoma solely presenting as multiple subcutaneous nodules.

Lymphomas may involve the subcutaneous tissue as a manifestation of generalized disease. However, they rarely present with multiple involvement of the subcutaneous fat tissue without other sites of the disease. We describe a patient with CD5+ diffuse large B cell lymphoma (DLBL) that was confined to the subcutaneous tissue.

Brain metastases of malignant melanoma showing unbalanced whole arm chromosomal translocations der (8; 14) (q10; q10) and der (11; 15) (q10; q10) in a Japanese patient.

Since malignant melanoma is a rare malignancy in Japan, little is known about the cytogenetic abnormalities in Japanese patients. We report a case of malignant melanoma showing complex chromosomal abnormalities. A 70-year-old woman was admitted to our hospital because of anorexia, delirium, and right hemiplegia.

Myelodysplastic syndrome progresses rapidly into erythroleukemia associated with synchronous double cancers of the stomach and the papilla of Vater.

Patients with myelodysplastic syndrome (MDS) show a relatively high incidence of developing cancers. However, it is extremely rare that synchronous double cancers develop in an MDS patient. We report a case of MDS that progressed rapidly into erythroleukemia (M6 by French-American-British classification) complicated by gastric cancer and carcinoma of the papilla of Vater.

[Association of idiopathic thrombocytopenic purpura and type 1 diabetes mellitus in a patient with sarcoidosis].

Occurrence of autoimmune diseases with sarcoidosis is well known. However, a case in which more than one of these diseases coexist with sarcoidosis is rare. We present a young man with suspected sarcoidosis, complicated by idiopathic thrombocytopenic purpura (ITP) and type 1 A diabetes mellitus (DM).

Clinical factors associated with post-ictal headache in patients with epilepsy.

Objectives: To determine the incidence of post-ictal headaches (PIH) and clinical risk factors associated with the occurrence of PIH in patients with localization-related epilepsy.

Materials And Methods: The subjects were 77 patients with temporal lobe epilepsy (TLE), 34 patients with occipital lobe epilepsy (OLE), and 50 patients with frontal lobe epilepsy (FLE). The subjects were directly asked whether headaches occurred just after seizures.

A comparison of post-ictal headache between patients with occipital lobe epilepsy and temporal lobe epilepsy.

We investigated post-ictal headaches (PIH) using a questionnaire to ascertain their characteristics and compare them among different types of epilepsy. The subjects consisted of 34 patients with occipital lobe epilepsy (OLE) and 75 patients with temporal lobe epilepsy (TLE). PIH occurred in 62% of OLE and 23% of TLE (P < 0.

Inappropriate microvascular constriction produced transient ST-segment elevation in patients with syndrome X.

Objectives: The aim of this project was to study the responsible site(s) and underlying cardiac disease(s) of patients with transient ST-segment elevation and normal coronary angiograms.

Background: Transient ST-segment elevation has been demonstrated in patients with variant angina or unstable angina. In those patients, epicardial coronary arteries, not microvessels, are always the responsible site for the transient ST-segment elevation.

[Is reduced left ventricular volume related to mechanisms of dynamic mid-ventricular obstruction provoked by dobutamine infusion?].

Forty-seven patients with unexplained chest pain and normal resting echocardiograms were examined to see whether dynamic mid-ventricular obstruction (MVO) is induced by dobutamine infusion. Dynamic MVO was provoked in 17 patients (MVO group), but not in the other 30 patients (Non-MVO group). Before dobutamine infusion, the blood pressure in the MVO group was higher than that in the Non-MVO group (p < 0.

Relation between dynamic midventricular obstruction and unexplained chest pain in patients with normal echocardiograms at rest.

The relation between dynamic mid-ventricular obstruction provoked by dobutamine infusion and chest pain was investigated in 16 patients with normal echocardiograms at rest who had histories of unexplained chest pain. Chest pain was induced in 63% of dynamic mid-ventricular obstruction and beta blockers suppressed either dynamic mid-ventricular obstruction or Chest pain.

[Otoacoustic emissions of full-term and preterm neonates].

Transiently evoked otoacoustic emission (TEOAE), distortion product otoacoustic emission (DPOAE), and spontaneous otoacoustic emission (SOAE) were measured in 45 full-term neonates (68 ears) and 12 preterm neonates (20 ears) with ILO88 & 92. Measurements were performed in the nursery of the obstetrics ward or NICU (not sound proof room) under natural sleeping condition after nursing. No sedating agent was used.

[Primary care considerations--17-ketosteroid sulfate-17-hydroxycorticosteroid method as a clinical stress indicator].

In primary care, the management of stress-related diseases occupies a wide spectrum of prevention and treatment, from holistic health care to final cure, centered on medical health and an organic integration of body, mind, and social parameters. Inquiries are being made at examinations and interviews to obtain information on the health condition of the patient, but, they are inadequate. There is a need for an objective indicator to help in the diagnosis.

[Considerations in clinical testing--implications of urinary 17-ketosteroid sulfate and 17-hydroxycorticosteroid measurements for stress research].

With the recent increase in number of patients with stress, the search is continuing for health-indicators that can be used to determine stress reliably and quickly. These indicators rely on subjective evaluations, and the establishment of an objective method of determining stress is necessary. We have developed a method involving the determination of the 17-Ketosteroid sulfates (17-KS-S) which has proved valuable for stress research.