Slit ventricle syndrome successfully treated by a lumboperitoneal shunt.

The authors present the case of a 17-year old man with slit ventricle syndrome, presenting as progressive neurological deterioration after head trauma. Serial computed tomography scans revealed slight ventricular enlargement, suggesting shunt malfunction. Communication between the lumbar subarachnoid space and the lateral ventricles was confirmed by computed tomography cisternography.

[A case of histological complete remission by preoperative intraarterial infusion chemotherapy].

We experienced a case of histological complete remission by preoperative intraarterial infusion chemotherapy in the treatment of histologically diagnosed endometrial cancer of well differentiated type. MRI demonstrated invasion of the myometrium to a depth of more than 1/2 and left partial parametrium. This patient was given intra-uterine arterial infusion chemotherapy twice (CDDP & ADM ia, CPA iv).

[Sarcoidosis with hypercalcemia and increased 1 alpha, 25-dihydroxyvitamin D in lung tissue].

A 60-year-old woman was admitted to our hospital complaining of nausea, thirst, and dyspnea on exertion. She had skin eruptions on her back and right knee. Her serum calcium level was 12.

[Shortening of hospitalization period for patients with pulmonary tuberculosis].

The development of specific chemotherapeutic agents revolutionally improved the prognosis of tuberculosis and markedly shortened the duration of the treatment. Evidence of successful treatment with short-course regimens for pulmonary tuberculosis has been accumulated. But, the duration of hospitalization tends to be determined empirically and varys among hospitals and clinicians.

[A case of pulmonary, pleural, and renal tuberculosis associated with DIC and a prolonged increase in D-dimer].

A 26-year-old male who had been diagnosed as pulmonary tuberculosis three years ago with an antituberculous chemotherapy of only two months, complained of tiredness, exertional dyspnea and fever since a month ago. Bloody sputum, bloody stool and hematuria have developed three days before admission. Petechiae over the body trunk and lower extremities were observed on admission.

[Hodgkin's disease initially presenting as vertebral lesions and a solitary pulmonary nodule--a case report].

Hodgkin's disease rarely involves bones and lungs without causing marked lymph node enlargement. The case of a 36 year old man, who initially presented with vertebral lesions and a solitary nodule in the lung, is reported. At the initial presentation, no apparent lymph node enlargement was observed.

[A case of Wegener's granulomatosis with episcleritis, mediastinal lesions, and pleural effusion and without serum anti-neutrophil cytoplasmic antibodies].

We report a 63-year-old male case of Wegener's granulomatosis. His complaints were cough and fever, and chest X-ray showed subpleural infiltrative opacities in the bilateral lungs and small nodular lesions in the middle portion of the right lung. He had been treated as bacterial pneumonia at another hospital without any improvement and was referred to this hospital.

[Urinary incontinence following total prostatectomy--evaluation by urodynamics and urethrography].

Urinary incontinence following total prostatectomy was evaluated in 10 patients by urodynamics and lateral urethrography. The pathological stage of the tumors in these patients was pT2 in 5 patients, pT3 in 3 patients and pT4 in 2 patients. Urinary incontinence was present in 8 patients, of whom 7 were stress incontinence and one was urge and stress incontinence.

[Intra-arterial infusion chemotherapy for advanced uterine cancer before surgical treatment].

Three cases of advanced uterine cancer were treated by CDDP intra-arterial infusion chemotherapy before curative operation. In Case I (stage IVb, G2), chemotherapy was done by BOAI method before radical hysterectomy and by implantable reservoir system after operation. In Case II (IIIa, G1), modified radical hysterectomy could be performed after chemotherapy using an implantable reservoir system, though inoperable at first.

[Hepatic arterial infusion chemotherapy combined with calcium antagonist for liver metastases].

We noticed inactivation of calcium antagonists in liver and investigated treatment with combined intraarterial chemotherapy. Both verapamil (VER) and adriamycin were infused into the hepatic artery of patients with liver metastases. The serum concentration of VER in the hepatic vein was 0.

[Therapeutic effect of hemodialysis on gouty arthritis and tophi in 2 patients with chronic renal failure].

Therapeutic effect of hemodialysis on gouty arthritis and tophi in 2 patients with chronic renal failure (CRF) is described. One patient was 74-year-old man with CRF due to benign nephrosclerosis, and had severe secondary gout. There were many tophi in metatarsophalangeal joints of the fingers and toes.

Subdural-peritoneal shunt: one-piece design with a large flushing device.

In an effort to maximize the effectiveness of subdural-peritoneal shunting for the treatment of chronic subdural hematoma in infants, the author developed a new shunt system. The characteristics of this shunt include a large-caliber catheter, a very low pressure slit valve, and a one-piece design with a large flushing device. This shunt is particularly useful for patients without increased intracranial pressure, who are usually refractory to treatment using a conventional ventriculoperitoneal shunt system.

Symptomatic cerebral vasospasm manifested 18 days after aneurysmal subarachnoid haemorrhage.

A patient who suffered rapid deterioration due to cerebral vasospasm 18 days after aneurysmal subarachnoid haemorrhage is reported. Unusually delayed onset of ischaemic neurological deficits and its preventative management is discussed.

Pitfall in clipping of unruptured cerebral aneurysms: narrowing of the parent artery.

Two patients with unruptured cerebral aneurysms are presented, who were complicated by transient ischaemic neurological deficits after seemingly uneventful neck clipping. Postoperative angiography disclosed narrowing of the parent arteries. Arteriosclerotic thickening of the wall of the aneurysmal neck and the parent artery was presumed to be the cause of the narrowing.

Vertebral artery aneurysm at the level of the cervicomedullary junction--case report.

A 39-year-old male presented with a ruptured vertebral artery aneurysm at the level of the cervicomedullary junction. Neuroradiological imaging demonstrated the aneurysm but not the anatomical relationships. Surgery in the chronic stage revealed that the aneurysm arose from the lowest part of the intradural vertebral artery.

Computed tomography features immediately after replacement of haematoma with oxygen through percutaneous subdural tapping for the treatment of chronic subdural haematoma in adults.

In an effort to achieve a simple and less invasive method for the treatment of chronic subdural haematoma, replacement of the haematoma with oxygen by percutaneous subdural tapping was employed in 36 patients. This study was conducted on 23 haematomas in 20 patients, whose computed tomography (CT) scans immediately following the treatment were available for evaluation, with particular regard to distinguishing between their findings and those seen with tension pneumocephalus. The CT features were divided into two patterns according to the location of oxygen; a convexity type (19 haematomas) and an interhemispheric type (4 haematomas).

[Results of total prostatectomy for treatment of prostatic cancer].

Between 1970 and 1989, total prostatectomy was performed in 31 patients with prostatic cancer at the Department of Urology, Tokyo Metropolitan Fuchu Hospital. These cases were composed of 4 cases of stage A, 8 cases of stage B and 19 cases of stage C. The surgical procedures were perineal prostatectomy in 25 cases, combined method of perineal and retropubic prostatectomy in 5 cases and transsacral prostatectomy in one case.

[Four cases of Hodgkin's disease treated with MOPP/ABV hybrid regimen using nitrogen mustard-N-oxide hydrochloride].

Four patients with fresh Hodgkin's disease were treated with MOPP/ABV hybrid regimen using nitrogen mustard-N-oxide hydrochloride (NH2-O). All patients responded well to this therapy and achieved complete remission. Toxicity was minimum except for an older patient.

[Resection of a mediastinal teratoma that perforated the lung and combined with aspergilloma in the tumor cyst].

We hereby report a rare case of a mature type teratoma that perforated the lung and combined with aspergilloma in the tumor cyst. The patient was a 48-year-old female, who complained of coughing and sputum. The chest roentogenography and chest CT suggested aspergilloma.

A new therapeutic method for chronic subdural hematoma in adults: replacement of the hematoma with oxygen via percutaneous subdural tapping.

Seeking radical removal of chronic subdural hematoma using a simple and less invasive procedure, the author has devised a new method--replacement of the hematoma with oxygen via percutaneous subdural tapping. In this study, 40 patients were treated with this procedure. All patients made a full recovery after the treatment, without complications related to replacement of the hematoma with oxygen.

[A complication of bronchoscopical brushing cytology and biopsy for pulmonary tuberculoma].

Although bronchoscopical brushing cytology and biopsy are useful tools for differential diagnosis of localized abnormal lung shadows, they have some complications, one of which is bacterial infection. The patient was a 42-year-old female with a RUL coin lesion on chest roentgenogram, which was diagnosed as pulmonary tuberculoma through the bronchoscopical examination. The exam.

[A case of stage IVb ovarian carcinoma successfully treated with intra-arterial infusion chemotherapy using implantable reservoir system].

A patient with liver metastasis from ovarian cancer was treated by intra-arterial infusion chemotherapy (well differentiated adenocarcinoma--CDDP 50 mg/body, ADR 30 mg/body, CPA 500 mg/body (iv)). After the chemotherapy, the metastatic tumor appeared remarkably smaller and could be resected successfully at the second reduction surgery. This patient is active 30 months after the first appearance and enjoying a favorable quality of life.

[A clinical trial of arterial infusion chemotherapy combined with calcium antagonist for liver metastases].

Calcium antagonists enhance the effect of some anticancer agents, but only limited administration is feasible because of their cardiovascular action. We noticed their inactivation in liver and investigated the possibility of combined intra-arterial chemotherapy. Both verapamil (0.

[Ventilation and passages in the middle ear. A study by HRCT in patients with attic cholesteatoma].

Operative records of 75 patients with acquired attic cholesteatoma were evaluated and compared with preoperative HRCT findings. The cholesteatoma extensions were classified into five groups as follows; Group 1 (cholesteatoma limited to the attic, 9 cases), Group 2 (cholesteatoma occupying both the attic and the aditus, 5 cases), Group 3 (cholesteatoma extending down to the posterior tympanum, also occupying an area as in Group 2, 6 cases), Group 4 (cholesteatoma occupying the attic, the aditus and the mastoid antrum, 14 cases), and Group 5 (cholesteatoma extending down to the posterior tympanum, also occupying an area as in Group 4, 41 cases). Ventilatory conditions, or the existence of soft tissue density, were evaluated by HRCT at such locations as the supratubal recess, mesotympanum, anterior and posterior parts of the tympanic isthmus, epitympanum, and mastoid antrum.