Isolated unilateral absence of the left pulmonary artery: a case report.

We report the case of a 37-year-old man with isolated unilateral absence of the pulmonary artery (UAPA), which was diagnosed upon the occurrence of hemoptysis. Plain chest radiography demonstrated decreased left pulmonary volume. Computed tomography of the chest revealed the complete absence of the left pulmonary artery.

Critical ventriculo-peritoneal shunt failure due to peritoneal tuberculosis: Case report and diagnostic suggestions for abdominal pseudocyst.

Background: Tuberculous peritonitis (TBP) is a well-known complication of ventriculo-peritoneal (VP) shunt treatment for hydrocephalus resulting from tuberculous meningitis (TBM). However, a case of hydrocephalus unrelated to TBM resulting from VP shunt malfunction due to TBP has not been reported.

Case Description: A 21-year-old male presented with nausea, abdominal pain, and headache.

Diagnostic utility of unenhanced computed tomography for acute aortic syndrome.

Background: The diagnostic value of unenhanced computed tomography (CT) for diagnosing acute aortic dissection (AAD) and ruptured thoracic aortic aneurysm (TAA) remains unclear.

Methods And Results: We examined 219 consecutive patients who visited the emergency room with suspected acute aortic syndrome (AAS) because of chest or back pain and who underwent both unenhanced and contrast-enhanced 64-row multi-detector CT. The unenhanced CT findings were evaluated by the cardiologist on duty who was blind to the findings of contrast-enhanced CT.

[Metastatic collecting duct carcinoma with relatively long-term survival treated with sunitinib: a case report].

A 51-year-old man visited our hospital with a chief complaint of left renal mass detected by ultrasonography in another hospital. Enhanced computed tomography (CT) revealed a hypovascular tumor measuring about 9 cm in the left kidney, tumor thrombus in the inferior vena cava and paraaortic lymph nodes metastases. Radical left transperitoneal nephrectomy with removal of the thrombus from the left renal vein were performed.

[A case of multiple bony pain due to metastatic malignant pheochromocytoma successfully treated with strontium-89].

A 50-year-old woman complaining of right flank pain visited our hospital. Computed tomography revealed adrenal gland tumor measuring 10 cm in diameter, and multiple bone and liver metastases. It was diagnosed as a malignant pheochromocytoma by means of endocrinological examination and metaiodobenzylguanidine scintigraphy.

A rare case of mechanical bowel obstruction caused by mesh plug migration.

Tension-free hernia repair with a mesh plug is currently one of the most popular techniques for open inguinal hernioplasty. It is well tolerated by most patients and is associated with few complications. However, rare mesh migration has been reported.

Thrombocytopenia induced by diazoxide in a patient with an insulinoma.

A 24-year-old healthy woman presented at our hospital due to hypoglycemia. A fasting test provoked spontaneous hypoglycemia, and contrast-enhanced abdominal computed tomography revealed a pancreatic tumor. We diagnosed her with insulinoma and initiated diazoxide treatment to prevent hypoglycemia.

Intracellular Propionibacterium acnes infection in glandular epithelium and stromal macrophages of the prostate with or without cancer.

Background: Recent reports on Propionibacterium acnes (P. acnes) suggest that this bacterium is prevalent in the prostate, is associated with acute and chronic prostatic inflammation, and might have a role in prostate carcinogenesis.

Methods: To evaluate the pathogenic role of this indigenous bacterium, we screened for the bacterium in radical prostatectomy specimens using enzyme immunohistochemistry with a novel P.

[Intensive care unit-acquired weakness: development of polyneuropathy and myopathy in critically ill patients].

Critically ill patients in the intensive care unit (ICU) often develop ICU-acquired weakness, which is characterized by acute or subacute onset diffuse limb weakness, during the early course of their severe illness and is related to prolonged mechanical ventilation, ICU stay, hospital stay, and even increased mortality. The development of generalized weakness or paralysis may be because of critical illness polyneuropathy (CIP), critical illness myopathy (CIM), and a combination of both. The basic mechanisms underlying these disorders are complex and poorly understood.

Japanese Guideline for Occupational Allergic Diseases 2014.

In 2013, a guideline for occupational allergic diseases was published for the first time in Japan. Occupational allergic diseases are likely to worsen or become intractable as a result of continuous exposure to high concentrations of causative antigens, and are socioeconomically important diseases with which the patients might sometimes lose jobs due to work interruptions. Guidelines for occupational allergic diseases have been published in many countries.

Experimental chemonucleolysis with recombinant human matrix metalloproteinase 7 in human herniated discs and dogs.

Background Context: Chemonucleolysis has been proposed as a less invasive technique than surgery for patients with lumbar disc herniation. Once chymopapain had been approved as a chemonucleolysis drug, it was withdrawn because of serious complications. A novel agent with fewer complications would be desirable.

[Mediastinal bronchogenic cyst causing severe tracheal stenosis].

An 86-year-old female patient was transported to our hospital because of progressive dyspnea. Computed tomography revealed a 7-cm-diameter low-density mass located in the upper mediastinum behind the trachea. The mass compressed the trachea and caused severe tracheal stenosis.

[A case of male infertility caused by drug-induced hyperprolactinemia].

A 46-year-old man complaining of infertility was referred to our hospital. He was diagnosed with oligozoospermia, asthenozoospermia and hyperprolactinemia probably induced by sulpiride for depression, because semen quality gradually improved after cessation of sulpiride administration. Five months after the cessation, his serum prolactin level declined to the normal level, and his wife achieved spontaneous pregnancy.

Cardiopulmonary arrest caused by coronary spasm after coronary vasodilator withdrawal during the peri-operative period of gastrectomy.

Calcium antagonists, nicorandil and long-acting nitrates are highly effective for preventing coronary spasm. The withdrawal of coronary vasodilators, especially calcium antagonists, is risky in cases of vasospastic angina. We herein present a case of cardiopulmonary arrest that occurred due to coronary spasm triggered by the discontinuation of coronary vasodilators during the peri-operative period of gastrectomy.

[A case of interstitial lung disease due to sunitinib].

A 64-year-old Japanese man who presented with a left renal mass (diameter, 9 cm) and multiple lung metastases, underwent translumbar left radical nephrectomy. Histological examination revealed the presence of clear cell-type, G3, pT3b renal cell carcinoma. Interferon-alpha (IFN-α) was administered postoperatively.

Double recurrence of group B streptococcus bacteremia in an immunocompetent infant.

We report an immunocompetent infantile case wherein group B streptococcus bacteremia recurred two times. The isolated bacteria which colonized in his nasopharyngeal cavity might be a source of repetitive infection. Although the best action has not been established yet, penicillin G as the prophylaxis seemed to be effective in this case.

[A case of secondary Paget's disease of the glans penis originating from bladder cancer].

An 81-year-old man had undergone total cystectomy and bilateral ureterocutaneostomy at the age of 66 years. Furthermore, no recurrence or metastasis was observed; but at the age of 80 years he observed a painless rash around the external urethral orifice. As urothelial cancer was suspected, the urethra and glans were biopsied.

[Treatment of heat stroke].

Immediate cooling and support of organ-system function are the two main therapeutic objectives in patients with heat stroke. When cooling is rapidly initiated and both the body temperature and cognitive function return to the normal range within an hour of onset of symptoms, most patients recover fully. Immersion in an ice-water bath is the most effective cooling method, and evaporative cooling is a rapid and effective alternative.

[Adrenocortical carcinoma detected by retroperitoneal hemorrhage : a case report].

Spontaneous massive retroperitoneal hemorrhage from an adrenal tumor is rare and is usually fatal if unrecognized. We report a case of spontaneous rupture of a primary adrenocortical carcinoma that occurred in a 79-year-old man. He visited our hospital with left abdominal pain.

[Renal metastasis from prostatic adenocarcinoma : a case report].

We report a case of renal metastases from prostate cancer to show that the possibility of tumor metastasis, although rare, should be considered in the differential diagnosis of renal mass. A 67-year-old man was found to have a renal mass on computed tomographic scan incidentally. He had had total androgen blockage (bicalutamide + leuprolerin) and chemotherapy (docetaxel hydrate ) for treatment of prostate cancer discovered 33 months ago.

Factors leading to failure to diagnose acute aortic dissection in the emergency room.

Background: Acute aortic dissection (AAD) is often missed on initial assessment.

Purpose: The aim of our study was to identify features associated with misdiagnosis of AAD.

Methods And Results: We examined a total of 109 emergency room (ER) patients who were ultimately diagnosed with AAD.