Double Common Bile Duct with Ectopic Drainage into the Stomach Found in Asymptomatic.

The case of a patient with asymptomatic double common bile duct that was identified by chance is presented. A 41-year-old man underwent esophagogastroduodenoscopy(EGD) as part of a regular health checkup, during which he was found to have an elevated lesion in the lesser curvature of the upper gastric corpus with bile draining from its tip. Further examination led to a diagnosis of double common bile duct from the left intrahepatic bile duct to the opening into the stomach.

Fingolimod-induced leukoencephalopathy in a patient with neuromyelitis optica spectrum disorder.

Fingolimod (FTY720) is used for reducing the annualized relapse rate and slowing progression of neurological disability in relapsing-remitting forms of multiple sclerosis (MS). However, its safety is not confirmed in patients with neuromyelitis optica spectrum disorder (NMOSD), who characteristically have positive aquaporin-4 (AQP-4) antibody. A 54-year-old female with a relapsing-remitting course of optic neuritis and myelitis for six years, diagnosed initially as MS, had been treated with interferon beta-1b and oral corticosteroid.

Impaired coronary metabolic dilation in the metabolic syndrome is linked to mitochondrial dysfunction and mitochondrial DNA damage.

Mitochondrial dysfunction in obesity and diabetes can be caused by excessive production of free radicals, which can damage mitochondrial DNA. Because mitochondrial DNA plays a key role in the production of ATP necessary for cardiac work, we hypothesized that mitochondrial dysfunction, induced by mitochondrial DNA damage, uncouples coronary blood flow from cardiac work. Myocardial blood flow (contrast echocardiography) was measured in Zucker lean (ZLN) and obese fatty (ZOF) rats during increased cardiac metabolism (product of heart rate and arterial pressure, i.

Clinical significance of an easy-to-use dual task for assessing inattention.

Purpose To investigate clinical significance of a newly developed paper-and-pencil type dual-task (Oiso-DT) for assessing inattention of brain-damaged patients. Methods A total of 134 healthy individuals and 44 patients with traumatic brain injury (TBI) were the subjects. Oiso-DT combined a cancelation sub-task and a written calculation sub-task on paper.

Bromocriptine Mesylate Attenuates Amyotrophic Lateral Sclerosis: A Phase 2a, Randomized, Double-Blind, Placebo-Controlled Research in Japanese Patients.

Objective: Bromocriptine mesylate (BRC), a dopamine D2 receptor agonist has been shown to confer neuroprotection, sustained motor function and slowed disease progression in mouse models of amyotrophic lateral sclerosis (ALS) Here we report a first in human trial in ALS.

Design: A multicenter, Riluzole add-on, randomized, double-blind, placebo controlled 102-week extension BRC clinical trial.

Methods: The trial was conducted between January 2009 and March 2012 on 36 Japanese ALS patients.

Postural deformities in Parkinson's disease -Mutual relationships among neck flexion, fore-bent, knee-bent and lateral-bent angles and correlations with clinical predictors.

Background: Various postural deformities appear during progression of Parkinson's disease (PD), but the underlying pathophysiology of these deformities is not well understood. The angle abnormalities seen in individual patients may not be due to distinct causes, but rather they may have occurred in an interrelated manner to maintain a balanced posture.

Methods: We measured the neck flexion (NF), fore-bent (FB), knee-bent (KB) and lateral-bent (LB) angles in 120 PD patients, and examined their mutual relationships, and correlations with clinical predictors such as sex, age, disease duration, Hoehn and Yahr (H&Y) stage, medication dose (levodopa equivalent dose, LED; total dose of dopamine agonists, DDA).

Celsior preserves cardiac mechano-energetics better than University of Wisconsin solution by preventing oxidative stress.

Objectives: Identity of the optimal heart preservation solution remains unknown. Because oxidative stress contributes to contractile failure in the ischaemic/reperfused myocardium and the main characteristic of Celsior is its antioxidant effect, it is important to elucidate the relationship between the inhibitory effect on oxidative stress and cardiac mechano-energetics. We therefore evaluated the efficacy of Celsior from both aspects by comparison with the University of Wisconsin solution (UWS).

Associations between venous thromboembolism onset, D-dimer, and soluble fibrin monomer complex after total knee arthroplasty.

Background: Prevention and early detection of venous thromboembolism (VTE) is important after arthroplasty of the lower limb. The purpose of this study was to investigate the associations between VTE and hemostatic markers after minimally invasive total knee arthroplasty (MIS-TKA).

Methods: We performed a retrospective study of 50 patients (55 knees) who underwent primary unilateral MIS-TKA with periodic determination of D-dimer and soluble fibrin monomer complex (SFMC) concentrations and with ultrasonography.

Exhalation immediately before inhalation optimizes dry powder inhaler use.

Objective: Although exhalation immediately prior to inhalation (EPI) from dry powder inhalers (DPIs) is universally advised, its benefit has not been investigated. The objective of this study to assess the effects of EPI on inhaled flow from a DPI.

Methods: We measured peak inhaled flow rate (PIFR) and inhaled gas volume of 25 volunteers unfamiliar with DPIs.

Reduction in amino-acid-induced anti-hypothermic effects during general anesthesia in ovariectomized rats with progesterone replacement.

Purpose: The aim of the present study was to determine whether the ovarian hormones, estrogen and progesterone, had different influences on amino-acid-induced anti-hypothermic effects during general anesthesia.

Methods: Ovariectomized Sprague-Dawley female rats were divided into four groups: those administered 17β-estradiol plus saline or an amino acid mixture (E2-Sal and E2-AA, respectively) and progesterone plus saline or an amino acid mixture (P-Sal and P-AA, respectively). Five weeks after ovariectomy, rats were given either E2 or P and then administered either Sal or AA solution for 180 min during anesthesia with sevoflurane.

Balloon-Occluded Retrograde Transvenous Obliteration for the Treatment of Gastric Varices: Polidocanol Foam Versus Liquid Ethanolamine Oleate.

Objective: The purpose of this study was to evaluate the clinical results of the management of gastric varices by balloon-occluded retrograde transvenous obliteration with polidocanol foam versus ethanolamine oleate.

Materials And Methods: Twenty patients treated with ethanolamine oleate and 21 patients treated with polidocanol foam were enrolled in this study. Early therapeutic effects were assessed mainly by dynamic contrast-enhanced CT.

Cytological Study of Grade 3 Endometrioid Adenocarcinoma of Endometrial Origin: Cytoarchitecture and Features of Cell Clusters Assessed With Endometrial Brushing Cytology--Focusing on a comparison with endometrioid adenocarcinoma Grade 1, 2.

Objectives: Aim of study was to clarify the cytological characteristics of grade 3 endometrioid adenocarcinoma of endometrial origin (G3 EA) by endometrial brushing cytology.

Methods: The subjects were 11 patients in whom G3 EA was diagnosed by review of preoperative cytological specimens obtained at our hospital and related institutions between 2000 and 2010. These patients were investigated with respect to the preoperative cytological diagnosis, background changes, cell cluster patterns, and individual cellular findings.

A Novel Multivariate Index for Pancreatic Cancer Detection Based On the Plasma Free Amino Acid Profile.

Background: The incidence of pancreatic cancer (PC) continues to increase in the world, while most patients are diagnosed with advanced stages and survive <12 months. This poor prognosis is attributable to difficulty of early detection. Here we developed and evaluated a multivariate index composed of plasma free amino acids (PFAAs) for early detection of PC.

Relationships among indoor, outdoor, and personal airborne Japanese cedar pollen counts.

Japanese cedar pollinosis (JCP) is an important illness caused by the inhalation of airborne allergenic cedar pollens, which are dispersed in the early spring throughout the Japanese islands. However, associations between pollen exposures and the prevalence or severity of allergic symptoms are largely unknown, due to a lack of understanding regarding personal pollen exposures in relation to indoor and outdoor concentrations. This study aims to examine the relationships among indoor, outdoor, and personal airborne Japanese cedar pollen counts.

Numerical Analysis of Organ Doses Delivered During Computed Tomography Examinations Using Japanese Adult Phantoms with the WAZA-ARI Dosimetry System.

A dosimetry system for computed tomography (CT) examinations, named WAZA-ARI, is being developed to accurately assess radiation doses to patients in Japan. For dose calculations in WAZA-ARI, organ doses were numerically analyzed using average adult Japanese male (JM) and female (JF) phantoms with the Particle and Heavy Ion Transport code System (PHITS). Experimental studies clarified the photon energy distribution of emitted photons and dose profiles on the table for some multi-detector row CT (MDCT) devices.

[Resistances of dry powder inhalers and training whistles and their clinical significance].

Background: Flow resistance of dry powder inhaler (DPI) is important information when physician choose a suitable DPI to individual patient. We previously reported flow resistances of several DPIs and training devices. In the present in vitro study, we measured resistances of new DPIs and new trainers.

Survival advantage of lanthanum carbonate for hemodialysis patients with uncontrolled hyperphosphatemia.

Background: Lanthanum carbonate is a non-calcium phosphate binder that is effective for the treatment of hyperphosphatemia. However, it is unknown whether treatment with lanthanum affects survival.

Methods: We retrospectively collected data on maintenance hemodialysis patients at 22 facilities (n = 2292) beginning in December 2008, a time point immediately prior to the commercial availability of lanthanum in Japan.

Tibia rotational technique to drill femoral bone tunnel in anatomic double-bundle anterior cruciate ligament reconstruction.

In anatomic anterior cruciate ligament (ACL) reconstruction, several pitfalls in creating the femoral bone tunnels at the correct position are of great concern. Our new method, the tibia rotational (TR) technique, may contribute to resolving these. The purpose of this study is to describe further details about the TR technique in anatomic double-bundle ACL reconstruction.

[Dynamic characteristics of flow trainer for dpi and its clinical relevance].

Background: Trainer devices are widely employed for flow instruction in the use of dry powder inhalers (DPI). However, their aerodynamic characteristics in actual use have yet to be investigated.

Methods: We recorded inhalation flow signals and sounds produced from trainers for Diskus®, Symbicort®, Pulmicort® and Twisthaler® while five volunteers inhaled from the trainers with various inhalation patterns.

Cytological analysis of uterine body endometrioid adenocarcinoma cells in peritoneal cavity: cytological findings and histological background.

Objective: We analyzed uterine-body endometrioid adenocarcinoma (EMA) cells appearing in the peritoneal cavity with special reference to squamous metaplastic-like cells (SMCs).

Methods: Cases were 33 EMA specimens surgically resected from 2000 to 2006 and consisting of 17 G1 (51.5%), 13 G2 (39.

Swallowing appliance: intraoral reshaping prosthesis for dysphagia secondary to oral floor cancer: a pilot study.

Patients with oral floor cancer often have difficulty swallowing solid foods. The aim of this study was to improve the propulsion of solid foods using a swallowing appliance (SW-A). Subjects comprised three patients with oral floor cancer who had undergone curative surgery.