Thymic Mucoepidermoid Carcinoma: A Clinicopathologic and Molecular Study.

Thymic mucoepidermoid carcinoma (MEC) is a rare tumor, and its characteristics remain to be clarified. Here we investigated 20 cases of thymic MEC to systematically characterize its clinical, histopathologic, and molecular features. The median age of the patients was 56 years (range, 19 to 80 y), there was a slight male predilection (3:2), and 44% of the patients were asymptomatic at diagnosis.

Enhancement of morphine-induced antinociception after electroconvulsive shock in mice.

Electroconvulsive therapy (ECT) has been applied for chronic pain for decades. The amounts of opioids to treat pain are sometimes reduced after a series of ECT. The effect of ECT on morphine-induced analgesia and its mechanism underlying the reduction of morphine requirement has yet to be clarified.

Chronic Thromboembolic Pulmonary Hypertension Associated with Chronic Inflammation.

Chronic thromboembolic pulmonary hypertension (CTEPH) is one of the leading causes of severe pulmonary hypertension. According to previously reported studies in the pertinent literature, chronic inflammatory conditions may be implicated in the development of CTEPH. We herein describe the case of a 56-year-old woman who was diagnosed with CTEPH in association with chronic infection.

Spondylodiscitis concurrent with infectious aortic aneurysm caused by Candida tropicalis: a case report.

We report a case of spondylodiscitis concurrent with infectious aortic aneurysm caused by Candida tropicalis in a 79-year-old immunocompromised man. The patient underwent percutaneous drainage of the abscess and endoluminal exclusion of the aneurysm using a bifurcated stent graft. Micafungin was administered intravenously for 8 weeks, followed by a prolonged course of oral fluconazole.

Marked improvement in leptomeningeal carcinomatosis and spinal cord metastases following alectinib treatment of crizotinib-resistant, ALK-positive lung adenocarcinoma.

We report a case of 50-year-old Japanese female with anaplastic lymphoma kinase (ALK)-positive, crizotinib-resistant lung adenocarcinoma, whose leptomeningeal carcinomatosis and spinal cord metastases were dramatically improved by the second-generation ALK inhibitor alectinib. Magnetic resonance imaging (MRI) revealed multiple brain metastases at diagnosis of lung cancer. Carboplatin/paclitaxel/bevacizumab chemotherapy was administered, but enlargement of brain tumors was observed after 3 months.

Susceptibility-weighted imaging in acute-stage pediatric convulsive disorders.

Background: The aim of this preliminary study was to investigate the clinical use of acute-stage susceptibility-weighted imaging (SWI) in children with prolonged convulsive disorder.

Methods: Ten children with prolonged convulsive disorder who underwent SWI within 2 h after termination of seizure (acute-stage SWI group) and 15 control children who underwent SWI > 2 h after their seizures terminated or for other purposes were enrolled. The cerebral venous vasculature was compared between the groups.

[Long-term survival following resection of primary rectal cancer metachronous metastases and salvage surgeries for relapsed lesions after stereotactic body radiotherapy for lung metastases - a case report].

A 66-year-old man underwent abdominoperineal resection for rectal cancer in 2003, followed by liver resection for a solitary liver metastasis in 2005. In 2006, the patient underwent abdominal para-aortic lymph node dissection, which was performed concurrently with partial resections of 3 metastases in the right lung. New metastatic lesions were subsequently diagnosed in S8 of the right lung and S1+2 of the left lung.

[Clinical analysis of delayed hemothorax due to diaphragmatic injury treated by emergent video-assisted thoracic surgery].

We encountered 5 cases of delayed massive hemothorax due to diaphragmatic injury. Delayed hemothorax presented 2∼11 days after injury, with lower rib fractures seen all cases. We performed emergent video-assisted thoracic surgery with mini-thoracotomy for all patients.

Protocol for splenic salvage procedures in this era of non-operative management.

Aim: The increased prevalence of non-operative management of splenic injuries contributes to the infrequent use of salvage procedures. Nevertheless, salvage procedures are sometimes required. The study aimed to evaluate the safety and feasibility of our salvage procedure protocol for selected patients.

[Locally advanced granulocyte colony-stimulating factor-producing non-small cell lung cancer successfully treated with concurrent chemoradiotherapy].

The prognosis of granulocyte colony-stimulating factor( G-CSF) -producing lung cancer is very poor. We present a case of G-CSF-producing locally advanced non-small cell lung cancer successfully treated with chemoradiotherapy. A 65-year-old man presented with a slight fever, general fatigue, and cough.

An unusual case of thoracic impalement injury with severe pleural adhesion.

Thoracic impalement injury is an uncommon form of trauma. In the present report, we describe the case of a 78-year-old man who was injured by 2 metal rods. We decided to remove the rod on the right side by performing video-assisted thoracic surgery.

Non-operative management of blunt liver injury: a new protocol for selected hemodynamically unstable patients under hypotensive resuscitation.

Background: The objective of this study was to evaluate our new protocol for performing non-operative management for selected unstable patients under hypotensive resuscitation using improved diagnostic imaging techniques.

Methods: This retrospective study included 77 consecutive patients with blunt liver injury. They were divided into two groups: those treated before and those treated after the revision.

Rheumatoid pleural effusion presenting as pseudochylothorax in a patient without previous diagnosis of rheumatoid arthritis.

Background: Rheumatoid pleurisy rarely occurs before a diagnosis of rheumatoid arthritis (RA). It is the second leading cause of pseudochylothorax, but there are few reports of RA-associated pseudochylothorax.

Case: A 50-year-old man presented to our hospital with an undiagnosed exudative pleural effusion.

Reassessment of declines in pulmonary function ≥1 year after stereotactic body radiotherapy.

Background: Stereotactic body radiation therapy (SBRT) is standard care for patients with inoperable early-stage non-small cell lung cancer. However, clinicians may hesitate to use SBRT in patients with severe COPD because of potential negative effects on pulmonary function. We quantitatively analyzed long-term declines in pulmonary function after SBRT to ascertain lifelong tolerability to SBRT.

Clinical characteristics of healthcare-associated pneumonia in a public hospital in a metropolitan area of Japan.

Healthcare-associated pneumonia (HCAP) is a new category that is essential in the present aging society. Knowing the different characteristics and outcomes between patients with HCAP and community-acquired pneumonia (CAP) would help physicians manage and treat HCAP patients. Although HCAP is thought to be heterogeneous in regions, there are no reports from a metropolitan area in Japan.

Severe COPD is correlated with mild radiation pneumonitis following stereotactic body radiotherapy.

Background: The primary cause of COPD and lung cancer is smoking. Thus, patients with COPD frequently have lung cancer that often is inoperable. Stereotactic body radiation therapy (SBRT) is anticipated to be the standard of care for inoperable early stage non-small cell lung cancer.

Cerebrospinal fluid and serum levels of vitamin B6 in status epilepticus children.

Vitamin B6 (B6) is an essential cofactor of glutamate decarboxylase and catalyzes the decarboxylation of the excitatory neurotransmitter glutamate to the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). Although immediate administration of B6 to patients with acute encephalopathy with febrile convulsive status epilepticus (AEFCSE) is effective, it is not known whether prolonged seizures in status epilepticus (SE) children prevent the transport of B6 to the central nervous system (CNS) and/or induce the consumption of B6 inside the CNS. We evaluated the B6 concentration in cerebrospinal fluid (CSF) and serum in SE children.

Atherosclerotic pseudoaneurysm of the left subclavian artery: a case report.

A subclavian artery aneurysm is rare. We report the case of a 61-year-old man with a history of hypertension and angina pectoris who was diagnosed with an atherosclerotic aneurysm of the left subclavian artery. An incidental computed tomography scan revealed a 37-mm saccular aneurysm adjacent to both the proximal left subclavian artery and the distal aortic arch.

[A case of sarcoidosis with an endobronchial polypoid lesion].

A 59-year-old woman complained of impaired vision. She visited an ophthalmologist and glaucoma was diagnosed. In July 200X, she was admitted to our hospital for further examination.

[Detection of pleural plaques on chest X-ray film by chest physicians].

With increasing awareness about health damage due to asbestos exposure, the number of people presenting with non-occupational exposure has increased remarkably. Consequently, chest physicians in general hospitals must read the chest X-ray films of patients with asbestos exposure. Can non-specialized chest physicians, who may have little experience of occupational medicine, diagnose pleural plaques accurately? The study subjects were 44 consecutive patients who were admitted to our hospital, under the Japanese medical health check system for workers employed in dangerous work.

Differences in the clinical characteristics of Pneumocystis jirovecii pneumonia in immunocompromized patients with and without HIV infection.

Background And Objective: The incidence of Pneumocystis jirovecii pneumonia (PCP) in patients with predisposing immunodeficiencies other than AIDS is growing. Knowing the different characteristics and outcomes of PCP according to HIV status would help physicians manage and treat patients with PCP.

Methods: The medical charts of all patients with a proven first episode of PCP, diagnosed between 1997 and 2007 were retrospectively reviewed, and clinical and laboratory data abstracted.