[A case of factor VIIICAg-positive severe hemophilia A with factor VIII inhibitor].
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Biomedical subjects
Publications and source records attributed to M Shima.
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Pure adenoma of the breast was seen in a 34-year-old Japanese woman. On examination, there was a firm, movable, nontender mass, 2.0 cm in diameter, in the upper outer quadrant of the left breast. The xeromammographic and macroscopical diagnosis was fibroadenoma. Histological examination, however, identified pure tubular adenoma of the breast. This was reported herein because of its extreme rarity.
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Subendocardial left ventricular aneurysmectomy relieved previously intractable ventricular tachycardia in a 68-year-old man with severe coronary artery disease. Staphylococcal septicemia developed postoperatively; an infected venoclysis site may have provided the portal of entry. Autopsy confirmed staphylococcal abscess at the epicardial aspect of the ventriculotomy, constituting the first reported case, to our knowledge, of this complication following endocardial surgery.
A case of mastopathy with cartilagenous and osseous metaplasia is reported. The patient is a 57-year-old Japanese woman complaining of a tumor measuring around 1.2 cm in diameter near the nipple of the left breast. The xeromammographic diagnosis was adenosis with calcification. Histological examination identified an intracystic tumor composed of papilloma and adenosis with cartilagenous and osseous metaplasia. This is the first Japanese case of its kind.
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A surgical case is described of a 40-year-old hemophilia A patient with a potent factor VIII inhibitor (40 Bethesda units) suffering from a chronic cystic haematoma in the right thigh. Surgery was performed after extensive plasmapheresis and administration of a large amount of factor VIII concentrate (42,500 U on the day of operation). During the five post-operative days, the factor VIII level was maintained above 25%, which allowed control of hemorrhage. However, two serious problems, i.e., hemolytic anemia and anamnestic response of factor VIII inhibitor titer, occurred on the 6th post-operative day. The hemolytic anemia was circumvented by administering prothrombin complex concentrate every 8 hours for 12 days until the sutures were removed. There was no bleeding although the inhibitor titer rose to 460 Bethesda units.
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A case report of a woman with spinal angiolipoma is presented, and it is stressed that spinal angiolipoma and spinal lipoma are two different clinicopathological entities which should be clearly distinguished.
A case is reported in which roentgenograms of the lumbar spine showed a vertical cleft in the superior articular process of the L-5 vertebra. The cleft seemed to be of no clinical significance.
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