Diffusion-weighted MRI for early diagnosis of neonatal herpes simplex encephalitis.

Aim: To determine the early changes and evolutions of brain diffusion-weighted imaging (DWI), and analyze prognostic factors of the early changes among patients with neonatal herpes simplex encephalitis (NHSE).

Method: We selected patients who developed encephalitis by 28 d after birth; had herpes simplex infection; and who underwent magnetic resonance imaging, including DWI, ⩽7 d of symptom onset. Thirty-two DWI scans between 0 and 28 d after onset in 13 patients and the clinical data were recruited.

A case of carcinoma ex pleomorphic adenoma in the buccal mucosa: review of the literature.

We present a case of carcinoma ex pleomorphic adenoma on the right buccal mucosa in a 52-year-old Japanese woman. Based on the histopathology, the excised tumor was the non-invasive type, but the majority of the tumor consisted of poorly-differentiated adenocarcinoma cells. We performed proton radiation after the surgery.

[Prosthetic valve re-replacement one year after the surgery using a mosaic bioprosthesis].

A 69-year-old man underwent aortic valve replacement with a 21 mm-Mosaic bioprosthetic valve for the treatment of aortic valve stenosis and resulting syncope. One year after the 1st operation, syncope recurred. Echocardiography showed non-symmetrical enlargement( ASH) of the ventricular septum as well as turbulence and increase of the pressure gradient in the left ventricular outlet.

[A surgical technique of tricuspid valve repair for infective endocarditis using an autologous pericardium].

We report a surgically treated case of tricuspid valve endocarditis. A 33-year-old man was diagnosed with ventricular septal defect (VSD) and active infective endocarditis associated with severe tricuspid regurgitation. Ultrasonic echocardiography (UCG) showed vegetations attached to the tricuspid valve.

[Clinical investigation of nine pediatric Japanese spotted fever cases].

To clarify the clinical manifestations of pediatric Japanese spotted fever (JSF), which remain unclear, we retrospectively reviewed the records of 9 consecutive hospitalized children 5 boys and 4 girls aged 0-15 years (median: 2.3) whose diagnosis was patients with JSF who were serologically confirmed from April 2008 to October 2009. We initially studied the polymerase chain reaction (PCR) assay validity for specific Rickettsia japonica DNA in the blood.

[Mitral valve replacement for heart failure due to hypertrophic obstructive cardiomyopathy; report of a case].

Myotomy or myectomy are well known as the standard treatment of hypertrophic obstructive cardiomyopathy (HOCM), and mitral valve replacement (MVR) is reported to achieve the equivalent therapeutic effect. And recently, combined treatment with artificial chordae replacement and MVR has been reported to improve the prognosis. We herein describe a case of a patient with HOCM who developed acute exacerbation of heart failure.

Acute motor-sensory axonal Guillain-Barré syndrome with unilateral facial nerve paralysis after rotavirus gastroenteritis in a 2-year-old boy.

Guillain-Barré syndrome (GBS) is well known as presenting with acute immune-mediated polyneuropathies, with strong associations with antecedent infections. Several variant forms of GBS have been described, including acute inflammatory demyelinating polyneuropathy, acute motor axonal neuropathy, acute motor-sensory axonal neuropathy, and sensory GBS. We present a rare case of 2-year-old boy with acute motor and sensory polyneuropathy and left-sided facial nerve paralysis after rotavirus infection.

[Resection of a metastatic left ventricular tumor with an aid of thoracoscopy].

A 61-year-old woman who complained of chest pain and cough was admitted to our hospital. She was diagnosed with multiple metastasis of breast or lung cancer, and a cardiac tumor was detected by echocardiography during chemotherapy. The tumor was located on the papillary muscle near the apex, had a smooth surface, and was well mobile.

[Treatment strategy of cardiac rupture due to blunt trauma].

Cardiac trauma is common in blunt injuries of the chest. However, survival after a cardiac rupture is not common, and only a certain percentage of the patients reach the hospital alive. We report on 3 cases of successful treatment of cardiac rupture due to blunt trauma; one by emergency surgical repair, and the others, conservative medical treatment.

Continuous saline bladder irrigation after transurethral resection is a prophylactic treatment choice for non-muscle invasive bladder tumor.

Background: Instillation of chemotherapy after transurethral resection (TUR) has been considered as an optimal treatment for non-muscle invasive bladder cancer (NMIBC). However, controversy remains regarding the role of chemotherapy instillation. We therefore evaluated the usefulness of continuous saline bladder irrigation (CSBI) after TUR.

Nadir PSA level and time to PSA nadir following primary androgen deprivation therapy are the early survival predictors for prostate cancer patients with bone metastasis.

The purpose of this study was to identify the early predictor of survival for prostate cancer patients with bone metastasis. We reviewed 87 prostate cancer patients with bone metastasis who had received primary androgen deprivation therapy (PADT) at our institution. The medical records of the patients were examined with respect to laboratory data, pathological results, PSA response to PADT and clinical outcome.

[A case of jejunal malignant melanoma diagnosed by enteroscopy and pre-operative biopsy].

We report a case of 72-year-old man found to have a primary malignant melanoma in the jejunum. The patient was noted to be anemic and had lower abdominal pain on his visit to the Department of Gastroenterology. However, an upper gastrointestinal series and colonofiberscopic examination revealed no abnormalities.

[Pulmonary actinomycosis which was clinically suggested lung cancer; report of a case].

A 57-year-old man had been observed a mass-like shadow on a chest radiograph. One year later, chest computed tomography (CT) revealed the enlargement of the shadow. Positive finding of fluorodeoxyglucose-positron emission tomography (FDG-PET) suspected lung cancer, and lingular segmentectomy was performed.

[Case of ipsilateral monoparesis by lacunar infarction: a consideration on the pathological mechanism].

An 81-year-old man had sudden-onset dysarthria and weakness in the right leg, and was admitted to our hospital in July 2009. Neurological examination showed right leg monoparesis, sensory disturbance on the right limbs, dysarthria, and decreased deep tendon reflexes. Brain MRI revealed an acute lacunar infarction in the right corona radiata and an old lacunar infarction in the left centrum semiovale, which occurred 4 years before.

Vaccine-associated paralytic poliomyelitis in an infant with perianal abscesses.

We describe a case of vaccine-associated paralytic poliomyelitis (VAPP) in a 7-month-old infant with perianal abscesses. The infant had suffered from perianal abscesses from 3 weeks after birth. The abscesses repeatedly developed and spontaneously drained through the orifice.

Successful treatment with paclitaxel/carboplatin chemotherapy in advanced adenocarcinoma of the urinary tract producing carcinoembryonic antigen, carbohydrate antigen 19-9 and carbohydrate antigen 125.

Primary adenocarcinoma of the urinary tract producing tumor markers is extremely rare. We report 2 cases of advanced adenocarcinoma of the urinary tract producing carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 125 (CA125), which were completely resected after induction chemotherapy with paclitaxel and carboplatin. Patient 1 was a 72-year-old woman with adenocarcinoma of the right renal pelvis and ureter.

Phase I/II study of tandem high-dose chemotherapy with autologous peripheral blood stem cell transplantation for advanced multiple myeloma.

The efficacy and safety of high-dose chemotherapy with tandem autologous peripheral blood stem cell transplantation (auto-PBSCT) were evaluated in a multicenter clinical study of patients with advanced multiple myeloma. Eligible patients (n = 40) were consecutively enrolled in the phase I/II study and received 2-4 cycles of vincristine-adriamycin-dexamethasone regimen. The responding patients underwent PBSC harvesting following high-dose cyclophosphamide and filgrastim administration.

Advanced atrioventricular block induced by obstructive sleep apnea before oxygen desaturation.

We report a patient with transient advanced atrioventricular (AV) block induced by obstructive sleep apnea (OSA). This 54-year-old man was diagnosed as having severe OSA and AV block with ventricular asystole for more than 6 s during overnight polysomnography, which occurred just from the onset of OSA before oxygen desaturation had occurred. An electrophysiological study revealed normal AV conduction system function and normal His-Purkinje system function.

Prevalence of Mycoplasma IgM in children with lower respiratory tract illness.

Background: Few data are available for the recent occurrence of Mycoplasma infections in children in Japan. The purpose of the present study was therefore to identify the prevalence of Mycoplasma infections in children in Japan.

Methods: IgM antibodies to M.

[Clinicopathological evaluation of preoperative chemotherapy with doxorubicin plus cyclophosphamide followed by paclitaxel for locally advanced breast cancer].

While the optimum regimen and therapeutic duration of preoperative chemotherapy have not been established for advanced breast cancer, the combination regimen of anthracycline series and taxane series, which has been well received as a postoperative chemotherapy, is also recommended for preoperative chemotherapy. We here present a clinicopathological evaluation of the safety and efficacy of the regimen and the predictors of the effectiveness of preoperative chemotherapy conducted retrospectively in patients with advanced breast cancer who were treated preoperatively with the combination of doxorubicin and cyclophosphamide followed by sequential weekly paclitaxel during the period between January 2004 and June 2007 at Yamada Red Cross Hospital. Eleven patients were treated preoperatively with the regimen during the study period.

Asymptomatic spontaneous rupture of a nonaneurismal visceral aorta.

Spontaneous nonaneurysmal rupture of the aorta is a life-threatening condition for which emergency diagnostic and therapeutic measures are indicated. An asymptomatic spontaneous aortic rupture was unexpectedly discovered adjacent to the visceral aorta. We diagnosed the mass as a pseudoaneurysm, and surgery was performed.

[Left ventricular pacemaker-lead implantation through left thoracotomy for cardiac resynchronization therapy].

We performed direct implantation of a left ventricular pacemaker-lead through left thoracotomy for cardiac resynchronization therapy (CRT). We exposed the left ventricular free wall using a pericardium lifting method without hemodynamic deterioration or arrhythmia. Intraoperative ultrasonic cardiography is useful for determining a suitable implantation site for CRT.

[Splenic marginal zone lymphoma associated with autoimmune hemolytic anemia treated with splenectomy and rituximab].

A 51-year-old woman, who presented with dyspnea on effort and was diagnosed with autoimmune hemolytic anemia in July 2004, was suspected of having splenic marginal zone lymphoma (SMZL) because of clonality of B cell on bone marrow and splenomegaly. She underwent splenectomy, and histopathological examination of the resected specimen confirmed the diagnosis of SMZL. The patient was treated with rituximab, and complete remission was achieved.