[A case of calcified chronic subdural hematoma wherein MRI was useful for decision of the treatment strategy].

Calcified chronic subdural hematoma is a rare condition, representing 0.4-2.6% of all chronic subdural hematomas.

Characterization of age-associated alterations of islet function and structure in diabetic mutant cryptochrome 1 transgenic mice.

Aims/introduction: In earlier reports, we described that transgenic (Tg) mice ubiquitously expressing cryptochrome1 (CRY1) with a mutation in cysteine414 (CRY1-AP Tg mice) show an early-onset insulin-secretory defect of diabetes mellitus resembling human maturity-onset diabetes of the young (MODY). To clarify the yet undiscovered molecular pathogenesis of diabetes mellitus in which the mutant of CRY1 is involved, we examined age-dependent characteristics of islets of CRY1-AP Tg mice.

Materials And Methods: Immunohistochemical analyses of islets were carried out for 2-, 4- and 19-week-old mice.

Combination therapy of eicosapentaenoic acid and pitavastatin for coronary plaque regression evaluated by integrated backscatter intravascular ultrasonography (CHERRY study)-rationale and design.

Background And Purpose: Many clinical trials have shown that 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) can significantly reduce coronary artery disease in both primary and secondary prevention. A recent study showed that aggressive lipid-lowering therapy with strong statins could achieve coronary artery plaque regression, as evaluated with gray-scale intravascular ultrasound (IVUS). However, it is unknown whether coronary plaque regression and stabilization are reinforced when eicosapentaenoic acid (EPA) is used with a strong statin.

[A case of metastatic colorectal cancer with hyperammonemic encephalopathy induced by 5-FU in a patient continuously treated with XELOX therapy].

We report a rare case of a patient with metastatic colorectal cancer who experienced hyperammonemic encephalopathy induced by 5 -fluorouracil(5-FU)and was continuously treated with capecitabine plus oxaliplatin(XELOX)therapy. A 60 years man with anorexia and weight loss was diagnosed with Stage IV rectal cancer, and chemotherapy with XELOX was initiated. When the second course of XELOX therapy was administered, the patient found it difficult to take oral capecitabine.

Primary retroperitoneal diffuse large B-cell lymphoma presenting with numb chin syndrome and painful ophthalmoplegia.

Numb chin syndrome (NCS) and painful ophthalmoplegia (PO) are neurological syndromes associated with the disturbance of certain cranial nerves and their downstream nerves. These syndromes are caused by various diseases, and, in rare cases precede the diagnosis of systemic malignant lymphoma. We herein present the case of a 59-year-old man diagnosed simultaneously with NCS and PO caused by a tumor located around the cavernous sinus and with diffuse large B-cell lymphoma that was identified via biopsy of a large retroperitoneal tumor.

Bilateral carotid and vertebral rete mirabile presenting with subarachnoid hemorrhage caused by the rupture of spinal artery aneurysm.

Rete mirabile (or carotid rete) is a normal structure that plays physiological roles in the lower mammals. However, the rete does not exist in the normal carotid circulation of humans. Carotid rete mirabile (CRM) is a rare condition compensating for congenital dysplastic internal carotid artery.

T-cell/histiocyte-rich large B-cell lymphoma of the thyroid.

T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) is a rare subtype of diffuse large B-cell lymphoma, and has been reported to mainly affect lymph nodes with advanced Ann Arbor stage. We present a 69-year-old woman with a past history of chronic thyroiditis, who had suffered from rapidly-growing thyroid tumor. No other lymph nodes swelling or extranodal lesions were detected.

CD20-positive and CD4/CD8-double-negative peripheral T-cell lymphoma of spleen complicated with severe disseminated intravascular coagulation and enteropathy.

A 71-year-old woman presented with massive splenomegaly. Open splenectomy was performed, and the diagnosis of peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), was made, with a characteristic immunophenotype of CD3(+), CD4(-), CD8(-), T-cell receptor (TCR)αβ(+), and TCRγδ(-). After splenectomy, she suffered abrupt exacerbation of the lymphoma with disseminated intravascular coagulation and enteropathy.

Successful treatment of acute promyelocytic leukemia accompanied by serious subdural hematoma.

We present a 56-year-old woman with acute promyelocytic leukemia (APL) complicated with serious chronic subdural hematoma at presentation. She was treated with urgent hematoma evacuation and subsequent prompt chemotherapy, with administration of platelets and fresh frozen plasma. After six weeks, she achieved hematological complete remission.

Relationship between kidney damage and stroke types in Japanese patients.

Background: Kidney disease is a known risk factor for stroke. This study investigated the relationship between kidney damage and stroke types.

Methods: A total of 525 incident stroke patients were registered and followed for 1 year.

[Successful management with partial splenic embolization (PSE) of splenomegaly and thrombocytopenia caused by oxaliplatin-based chemotherapy for advanced colorectal cancer].

We report here two cases of advanced colorectal cancer which received chemotherapy, in which partial splenic embolization (PSE) had been effective for controlling splenomegaly and thrombocytopenia. Case 1: A 50-year-old man presented with bloody urine and bloody stool. Computed tomography (CT) showed rectosigmoid cancer with urinary bladder invasion.

[Endoscopic pancreatic stenting was effective in a case of pancreatic duct disruption and leakage due to pancreatic cancer].

A 79-year-old man was admitted on the suspicion of acute pancreatitis. Computed tomography showed acute fluid collection but not typical acute pancreatitis; it formed pseudocysts gradually around the pancreas. Endoscopic retrograde pancreatography (ERP) revealed pancreatic disruption and leakage.

An enucleated duodenal gastrinoma with multiple type 1 endocrine neoplasia located by selective arterial calcium injection.

We report a duodenal gastrinoma in a 50-year-old man who was admitted to our hospital with tarry stools. Esophagogastroduodenoscopy revealed multiple ulcers in the duodenal bulb and a submucosal tumor in the descending duodenum. His serum gastrin level was 1400pg/ml.

[A case of metastatic colorectal cancer suffering from hyperammonemic encephalopathy induced by 5-FU, continuously treated with FOLFOX therapy].

We report a rare case of metastatic colorectal cancer who suffered from hyperammonemic encephalopathy induced by 5- FU and was continuously treated with FOLFOX therapy. A 50-year-old man with ileus was diagnosed with ascending colon cancer Stage IV, and a right hemicolectomy was performed. Postoperative chemotherapy with modified FOLFOX6 was performed.

[A case of primary hepato-biliary malignant lymphoma effectively treated with R-CHOP chemotherapy].

A 65-year-old man was admitted to our hospital because of obstructive jaundice caused by a mass extending in the porta hepatis, neck of gall bladder and extrahepatic bile duct. The specimens obtained with ultrasound-guided needle biopsy showed malignant lymphoma (diffuse large B-cell lymphoma: DLBCL). CHOP with Rituximab therapy (R-CHOP therapy) was performed.

A case of serous cystic tumor, which recurred with severe acute pancreatitis.

A 76-year-old woman with serous cystic tumor (SCT) was admitted to our hospital with abdominal pain and was given a diagnosis of severe acute pancreatitis. Infusion of intravenous protein inhibitor and continuous hemodiafiltration (CHDF) were started and she was placed on a respirator, but she died on the 6th day after diagnosis. On autopsy, each SCT cyst showed evidence of hemorrhage.

The IHPK1 gene is disrupted at the 3p21.31 breakpoint of t(3;9) in a family with type 2 diabetes mellitus.

Type 2 diabetes mellitus (T2DM) is a group of multifactorial disorders due to either defective insulin secretion or action. Despite the fact that numerous genetic researches of T2DM have been pursued, the pathogenic mechanisms remain obscure. We encountered a T2DM family associated with a balanced reciprocal translocation, t(3;9)(p21.

Univariate analysis of factors correlated with tumor control probability of three-dimensional conformal hypofractionated high-dose radiotherapy for small pulmonary or hepatic tumors.

Purpose: To show the factors correlated with tumor control probability (TCP) after three-dimensional conformal hypofractionated high-dose radiotherapy (3D-CHHRT) for small pulmonary or hepatic tumors.

Methods And Materials: We enrolled 34 patients with 42 lesions (13 lung carcinomas, 6 hepatocellular carcinomas, and 23 lung or liver metastases) treated with 3D-CHHRT alone, with simple immobilization devices, between July 1997 and January 2002. We prescribed 45 Gy in three fractions at the 90-100% isodose line of the planning target volume.

A case of exercise-induced acute renal failure in a patient with idiopathic renal hypouricemia developed during antihypertensive therapy with losartan and trichlormethiazide.

Exercise-induced acute renal failure (ARF) developed in a 45-year-old man during antihypertensive therapy with losartan and trichlormethiazide. The antihypertensive therapy was stopped and marked hypouricemia became apparent during improvement of his renal function. The daily urinary excretion of uric acid was normal and an increased fractional excretion of uric acid was observed.