Radiologic-clinical correlation. One-and-a-half syndrome associated with cheirooral syndrome.
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Biomedical subjects
Publications and source records attributed to S Shintani.
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Immunohistochemical analysis of erbB3, as the third member of epidermal growth factor receptor gene family, was performed on 41 cases of oral squamous cell carcinoma, correlating the staining pattern with clinical outcome. High expression of erbB3 protein (ERBB3) was significantly associated with lymph node metastasis (P < 0.05), survival rate (P < 0.05) and mode of invasion (P < 0.01) in this series. These results demonstrated that ERBB3 expression may be helpful in identifying those oral squamous cell carcinomas with higher malignant potential.
Two elderly patients with polymyalgia rheumatica (PMR), one with and the other without temporal arteritis (TA), are presented. Immunofluorescence study of muscle biopsy specimens showed IgG, IgA, and fibrinogen deposits in the perifascicular area in the perimysium. This finding suggests that immune complexes play a role in the pathogenesis of this condition and that the pathophysiology of PMR involves an interstitial inflammatory process.
A 23-year-old Japanese man presented with status epilepticus unresponsive to medication, respiratory failure, rhabdomyolysis, myoglobinuria, and irreversible renal failure. Muscle biopsy revealed type 1 fiber atrophy and an increased type 2C fibers (7%). His carnitine palmitoyltransferase (CPT) I and II activities were 0.06 and 0.12 nmol/min/mg protein, as compared with a mean value of 0.22 +/- 0.14 and 0.27 +/- 0.07 nmol/min/mg protein, respectively, in control subjects. This appears to be the first report of this disorder presenting as status epilepticus. Metabolic encephalopathy due to CPT deficiency may have presented as status epilepticus. Seizures in the present case may have resulted from the functional disorder of brain due to CPT deficiency.
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We present the rare case of a 62-year-old woman with Churg-Strauss syndrome associated with a left third nerve palsy and a mononeuritis multiplex. Cranial nerve palsies are unusual in patients with Churg-Strauss syndrome, and the most frequent cranial nerve lesion observed is an ischemic optic neuritis. Third nerve involvement secondary to vasculitis-induced ischemia is extremely rare in this disorder.
A 4-year-old Japanese boy was referred to Osaka University Dental Hospital because of severe mobility and pain of the right lower primary canine. The canine had severe bone loss and a pocket depth exceeding 5-6 mm. The left lower canine showed slight mobility and moderate alveolar bone loss. The other primary teeth showed no pathogenic findings. The subgingival microflora from the right lower canine was dominated by gram-negative rods, especially capnocytophaga and fusobacterium, while actinomyces sp. were the most common gram-positive bacteria. While neutrophil functions of the patient were within the normal ranges of healthy subjects, some lymphocyte functions such as IL-2 production and IgG and IgM syntheses were lower in the patient. 7 months after the extraction of the right lower primary canine, the patient complained of pain around the right lower primary lateral incisor. In 3-4 weeks, the alveolar bone was lost rapidly and mobility of the lower anterior teeth increased significantly. The primary lateral incisor was extracted and the other primary teeth were treated by sealing and systemic and local administration of antibiotics. After treatment, the lower anterior teeth became less mobile and the gram-positive cocci predominated.
The present report describes a patient who developed Graves' disease 3 months after inception of retreatment with higher doses of interferon-alpha 2a for chronic hepatitis C, although the initial 6-month treatment caused no serious adverse reactions. Severe hyperthyroidism continued despite discontinuation of interferon-alpha 2a, and the patient was subsequently treated with 131I. This case suggests careful evaluation of the safety of retreatment to prevent manifestation of such a complication in the retreatment of chronic hepatitis C with interferon.
A 71-year-old man with atrial fibrillation suddenly had an embolism in the right middle cerebral artery. Single-photon emission CT was performed 4 hours after the onset of stroke and revealed markedly elevated 99mTc-hexamethylpropyleneamine oxime (HMPAO) uptake in the right frontotemporoparietal region. This area of HMPAO hyperfixation corresponded to the area of infarction, as determined by CT and MR. Our findings showed that HMPAO single-photon emission CT overestimated reflow hyperemia after reperfusion in the acute stage of embolic stroke, as it does in the subacute stage.
The pharmacokinetics and its dose dependency of a new cephalosporin, DQ-2556, were studied in the rat and rabbit. The pharmacokinetics of the compound in the rat was linear up to a dose of 300 mg/kg; however, at a dose of 1200 mg/kg, renal clearance decreased dramatically and the normalized area under the blood concentration-time curve increased remarkably. On the other hand, there were no dose-dependent changes in tissue/serum concentration ratios, serum protein binding, red cell binding, and the distribution of DQ-2556. In the rabbit, the pharmacokinetics of DQ-2556 was linear even up to a dose of 1200 mg/kg and no unusual pharmacokinetic behavior was observed. The renal clearance experiments demonstrated that DQ-2556 is excreted by glomerular filtration. It was also shown that the glomerular filtration rate (GFR) remained constant up to a dose of 1000 mg/kg of DQ-2556 in the rat, whereas the GFR decreased by 95.1% at a dose of 1200 mg/kg. The coincidence of dose relationship and species difference in the disorder of GFR and renal toxicity suggests that the change of pharmacokinetics of DQ-2556 was caused by its renal toxic effects at very high dose.
BACKGROUND AND PURPOSE: We conducted this retrospective study to evaluate the clinical, neuroradiological, and neurophysiological findings in patients with pure sensory stroke due to pontine lacuna. SUMMARY OF REPORT: Four patients with pontine lacuna, three men and one woman (mean age, 64.5 years; range, 55 to 75 years), were evaluated. Magnetic resonance images were obtained with a 0.5-T superconducting magnet using the SE technique. Short-latency somatosensory evoked potentials were evaluated by unilateral stimulation of the median nerve at the wrist. These tests were done at a mean of 22.5 months (range, 9 to 34 months) after symptom onset. Deep sensory disturbances were present in one half of the patient's body with no other neurological deficits found. The sensory deficit was characterized by a prolonged period of refractory dysesthesia and a discrepancy between the superficial and deep sensory disturbances. Lesions were localized in the medial lemniscus of the middle and lower pons, with a sparing of the spinothalamic tracts. The central conduction times of short-latency somatosensory evoked potentials were prolonged (patients 1, 2, and 4), and the amplitudes were significantly reduced (patients 1 and 2) when stimulating the paresthetic-sided median nerve (contralateral side of the lesion) compared with stimulating the other side. CONCLUSIONS: In all cases, the clinical and radiological findings indicated a dysfunction of the medial lemniscal tract in the pons. The observed somatosensory evoked potentials were probably related to the persistent refractory dysesthesias present in these patients.
The present report concerns a patient who was first diagnosed as having adenoma in the duodenal bulb and subsequently was discovered to have adenomas in the stomach and colon. Surgical procedures including endoscopic resection could not be carried out because the patient had advanced liver cirrhosis. Follow-up colonoscopy no longer detected any polyp in the colon. Ultrasonography demonstrated a slowly growing hypoechoic mass in the liver, which was indicative of hepatocellular carcinoma. Then, single chemotherapy with oral administration of 5'-deoxy-5-fluorouridine was initiated. Surprisingly, repeated esophagogastroduodenoscopy revealed gradual regression of the gastric and duodenal tumors. Findings from the endoscopy and biopsy materials 10 months after the start of therapy showed disappearance of the gastric and duodenal adenomas. Despite enlargement of the hepatic mass, no recurrence of gastric and duodenal tumors has been noted during the past 1 1/2 yr.
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A case of hypertrophic cranial pachymeningitis is described and the MR appearance presented. A gadopentetate-dimeglumine-enhanced MR scan enhanced markedly suggesting thickening and inflammation of dura and falx cerebri. The patient, a 72-year-old elderly man, had surprisingly little clinical abnormality. His only neurological manifestation was progressive unilateral blindness. The exact cause of his pachymeningitis was unknown, though neither rheumatoid arthritis nor other collagen disease was completely excluded.
The Japan Poison Information Center (JPIC) was founded only 6 years ago as a result of co-operation between the Ministry of Health and Welfare, the Japanese Association for Acute Medicine, the Japan Pediatric Society and other related medical organizations. The JPIC is the only poison information center admitted by the Ministry of Health and Welfare to provide toxicological information to medical personnel and the general public, and has two offices on duty in alternating 24 h shifts. Every year, JPIC receives about 30,000 inquiries. About 82% of these inquiries are from the general public and 84% of the patients are children 5 years and younger. We contrasted the data in the fiscal year 1991 with the data of the American Association of Poison Control Centers (AAPCC). Child poison exposure in Japan is characterized by a high exposure rate of children under 1 year of age to (mostly) household products. The JPIC also analyzed the cause of tobacco ingestion. It is considered that the Japanese lifestyle causes differences from those reported by AAPCC. We report the accidental poisoning of children in Japan.
During a hypoglycaemic right hemiplegia induced by a deliberate overdose of oral hypoglycaemics, brain CT and angiography revealed no abnormalities. SPECTs made one day and six days later showed relative hypoperfusion in the left hemisphere. Repeat SPECT study suggested that the left hemisphere was more vulnerable than the right in the cerebral blood perfusion. This vulnerability might provoke the right hemiplegia in a critical condition, such as severe hypoglycaemia.