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Hiroshima Journal of Medical Sciences

Takahiro Zenda, Ichiro Araki, Naomichi Hamano, Hiroto Nishida, Masatoshi Ikeda, Hisashi Bunko, Tetsuya Aoki
Dissection of the splanchnic artery unrelated to an aortic lesion is extremely rare. We describe a patient with dissection of the celiac and splenic arteries causing splenic circulatory impairment. A 55-year-old Japanese man was referred to our hospital for left back pain that suddenly occurred 3 days previously and spread to the left flank. He had complicated sleep apnea syndrome well controlled with continuous positive airway pressure, and had been prophylactically taking aspirin (100 mg/day) because of asymptomatic cerebral lacunar infarcts...
March 2017: Hiroshima Journal of Medical Sciences
Yohji Honda, Masami Kubo, Shintaro Takaki, Nami Mori, Masaki Ishikawa, Hideaki Kakizawa, Keiji Tsuji, Yoshinari Furukawa
An 84-year-old woman was hospitalized due to consciousness disorder as hyperammonemia. She had no etiology of liver disease. Twelve months before the current admission, she had been diagnosed with dementia based on her low level of daily perception and physical activity. Abdominal computed tomography revealed a large portosystemic shunt between the medial branch of the portal vein and middle hepatic vein. After the improvement of her consciousness disturbance by medical treatment, percutaneous shunt embolization was electively performed...
March 2017: Hiroshima Journal of Medical Sciences
Yuki Imaoka, Masahiro Ohira, Shintaro Kuroda, Hiroyuki Tahara, Kentaro Ide, Kohei Ishiyama, Tsuyoshi Kobayashi, Masaki Ishikawa, Kazuo Awai, Hideki Ohdan
Regarding the treatment for a portosystemic shunt, surgical or interventional radiological closure of the shunt was established. Interventional radiology including balloon-occluded retrograde transvenous obliteration can worsen portal hypertension and create a large thrombus close to the major venous system in the case of a huge portosystemic shunt. In contrast, it is also difficult to treat some cases through surgery alone when huge complicated shunts exist very deep in the body. Herein, we report a successful case of surgical shunt ligation for portosystemic encephalopathy in a hybrid operation room that enabled intraoperative angiography and computed tomography...
March 2017: Hiroshima Journal of Medical Sciences
Hideo Ohba, Satoshi Yamaguchi, Takuro Magaki, Masaaki Takeda, Manish Kolakshyapati, Takashi Sadatomo, Kaoru Kurisu
Hemangioblastoma disseminated along leptomeninges from the solitary cranial lesion without von Hippel-Lindau (VHL) disease is a quite rare instance with 23 cases reported in 40 years. We add a new case and discuss these rare instances. A 55-year-old female underwent surgery for total removal of cerebellar hemangioblastoma. Twenty months later, magnetic resonance (MR) images of the spinal cord revealed a tumor compressing the thoracic cord at T3-4 level which was removed en bloc by emergent spinal surgery. However, paraplegia and bowel bladder dysfunction recurred 5 months after the spinal surgery...
March 2017: Hiroshima Journal of Medical Sciences
Mizuki Morishige, Masaaki Takeda, Satoshi Yamaguchi, Kazuhiko Sugiyama, Kaoru Kurisu
Transcranial electrical stimulation motor-evoked potential (TES-MEP) has been widely used to monitor major motor pathways in cranial and spinal surgeries. However, the results of TES-MEP might be strongly influenced by anesthetic agents and muscle relaxants. To compensate for this effect, a technique using compound muscle action potentials of the abductor pollicis brevis (APB-CMAP) evoked by median nerve stimulation has recently been reported. In this article, we adopted the transcranial electrical stimulation motor-evoked potential of facial muscles (TES-FMEP) instead of APB-CMAP as a reference waveform for compensation...
March 2017: Hiroshima Journal of Medical Sciences
Takeharu Imai, Kazuhiro Sentani, Kazuomi Yamashita, Naohide Oue, Kazuhiro Yoshida, Wataru Yasui
A 64-year-old male patient with a histological diagnosis of Russell body gastritis and with eosinophilic infiltrate in biopsy specimens is reported. The patient continued hemodialysis and pseudomembranous enteritis was contracted. Upper gastrointestinal endoscopy was performed due to poor appetite and blood eosinophilia. During endoscopy, a flare, swollen mucous membrane, and multiple verrucous erosions were noted in the gastric antrum. Biopsy and histopathological examination of gastric mucosa showed infiltration of plasma cells containing Russell bodies and eosinophils...
December 2016: Hiroshima Journal of Medical Sciences
Satoshi Sueoka, Toshiyuki Itamoto, Koichi Oishi, Tatsuro Ishimoto
Intussusception in adulthood is unusual. We describe herein a rare case of adult ileoileal intussusception caused by an ileal lipoma, which was diagnosed preoperatively and was confirmed at the operation to have reduced spontaneously. A 68-year-old woman experienced sudden-onset colicky pain in the upper abdomen accompanied by vomiting and was brought to our hospital by ambulance. Physical examination revealed a distended abdomen and tenderness in the upper abdomen. Laboratory findings showed slightly elevated inflammatory parameters...
December 2016: Hiroshima Journal of Medical Sciences
Prabin Shrestha, Anish M Singh, Rupendra B Adhikari, Geeta Sayami, Satoshi Yamaguchi, Kaoru Kurisu
Ganglioneuromas are rare benign tumors arising from neuroepithelial cells. Even more rarely they involve lumbar spinal nerve roots. We report a 34-year-old male patient who presented with typical lumbar radiculopathy. He had low back pain radiating to the right lower leg with numbness. His MRI revealed a herniated disc at L5-S1 compressing the right nerve root. Surgery was planned for microdiscectomy and nerve root decompression. Right L5 hemilaminotomy was performed and the nerve root was identified. Surprisingly the nerve root was markedly inflamed and there was no obvious disc tissue herniation...
December 2016: Hiroshima Journal of Medical Sciences
Manabu Shimomura, Masatoshi Kochi, Takao Hinoi, Hiroyuki Egi, Tomohiro Adachi, Tsuyoshi Kobayashi, Hirotaka Tashiro, Hideki Ohdan
Pharmacological prophylaxis was not routinely administrated following gastroenterological surgery because of concerns about bleeding complications. We tried to establish the original risk classification to determine the indication for pharmacological prophylaxis for selected patients at high risk of venous thromboembolism (VTE). One hundred and fifty-six consecutive patients who underwent lower abdominal elective surgery were divided into three groups (highest, high, and low risk groups) based on the original risk classification...
December 2016: Hiroshima Journal of Medical Sciences
Noriyuki Hara, Kenichi Satoh, Keiko Otani, Hideshi Kawakami, Megu Ohtaki
Heart disease (HD) mortality is the second leading cause of death in Japan. The HD mortality risk among Atomic bomb survivors is slightly positive but shows a statistically significant dose-response relationship with initial radiation dose, as reported by the Radiation Effects Research Foundation. In that report, dosimetry was based on initial radiation only, with the effect of indirect radiation dose not taken into consideration. The atomic bomb radiation, however, consisted of both initial and residual radiation...
September 2016: Hiroshima Journal of Medical Sciences
Junji Matsuba, Keiko Otani, Kenichi Satoh, Hideshi Kawakami, Megu Ohtaki
Several studies have been conducted on cerebrovascular disease mortality in Atomic bomb survivors. Previous studies have investigated the relationship between mortality and initial radiation dose after adjusting for the effects of sex and age at the time of the bombing (ATB), and detected a weak (but statistically significant) dose-response relationship was detected. The objective of the present study was to examine whether the sex- and age ATB-specific cerebrovascular disease mortality among Hiroshima atomic bomb survivors can be explained by the initial radiation dose...
September 2016: Hiroshima Journal of Medical Sciences
Masahiro Hatooka, Tomokazu Kawaoka, Hiroshi Aikata, Fumi Honda, Yuki Nakamura, Norihito Nakano, Kei Morio, Takayuki Fukuhara, Tomoki Kobayashi, Yuko Nagaoki, Masataka Tsuge, Akira Hiramatsu, Michio Imamura, Yoshiiku Kawakami, Kazuo Awai, Kazuaki Chayama
To assess the outcome of stable disease (SD) patients with advanced hepatocellular carcinoma (HCC) by tumor markers after the first course of hepatic arterial infusion chemotherapy (HAIC). The study subjects were 156 HCC patients treated with HAIC and classified as Child Pugh A, with no extrahepatic metastasis, and no history of sorafenib treatment. In the study and validation cohorts, the AFP and DCP ratios of patients who were considered SD to the first course of HAIC were analyzed by AUROC for a prediction of response to the second course of HAIC...
September 2016: Hiroshima Journal of Medical Sciences
Yuta Ibuki, Yoichi Hamai, Jun Hihara, Junya Taomoto, Takaoki Furukawa, Ichiko Yamakita, Morihito Okada
Patients with esophageal cancer often have various comorbidities, and these sometimes limit treatment choices. We describe a patient with stage IA esophageal cancer accompanied by interstitial lung disease (ILD). Endoscopic resection and radiotherapy were not appropriate because of clinically diagnosed submucosal invasion and the patient was at high risk of ILD exacerbation. We therefore selected transhiatal esophagectomy without a thoracotomy considering the risk of postoperative respiratory complications, and administered methylprednisolone and sivelestat in the perioperative period for the reduction of surgical stress...
March 2016: Hiroshima Journal of Medical Sciences
Kenjiro Okada, Takeshi Sudo, Katsunari Miyamoto, Yujiro Yokoyama, Yoshihiro Sakashita, Yasushi Hashimoto, Hironori Kobayashi, Hiroyuki Otsuka, Takuya Sakoda, Fumio Shimamoto
The localization and diagnosis of microgastrinomas in a patient with multiple endocrine neoplasia type 1 is difficult preoperatively. The selective arterial calcium injection (SACI) test is a valid diagnostic method for the preoperative diagnosis of these invisible microgastrinomas. We report a rare case of multiple invisible duodenal microgastrinomas with severe duodenal stenosis diagnosed preoperatively by using the SACI test. A 50-year-old man was admitted to our hospital with recurrent duodenal ulcers. His serum gastrin level was elevated to 730 pg/ml...
March 2016: Hiroshima Journal of Medical Sciences
Junichiro Ochiai, Satoshi Yamaguchi, Masaaki Takeda, Rupendra Bahadur Adhikari, Manish Kolakshyapati, Vega Karlowee, Kazuhiko Sugiyama, Kaoru Kurisu
We report a rare case of neonatal cutaneous meningioma derived from a rudimentary meningocele. This neonate had a congenital skin-covered hump in the thoracolumbar region. Computed tomography showed bifid laminae of T12 and L1 underneath the mass lesion. Magnetic resonance images showed the mass to have no cerebrospinal fluid space and that it had a stalk connecting to the spinal canal. Split cord malformation was also observed under the bifid laminae. Because of the increasing size of the lump and cosmetic reasons, the parents opted for surgical treatment...
March 2016: Hiroshima Journal of Medical Sciences
Yosuke Arima, Kanji Yoshimoto, Akira Namera, Ryosuke Makita, Kazuhiro Murata, Masataka Nagao
Organophosphorus compounds, such as sarin, are highly toxic nerve agents that inhibit acetylcholinesterase (AChE), but not cholinesterase, via multiple mechanisms. Recent studies have shown that organophosphorus compounds increase cyclooxygenase-2 (COX-2) expression and induce neurotoxicity. In this study, we examined the toxicity of the sarin-like organophosphorus agent bis(isopropyl methyl)phosphonate (BIMP) and the effects of BIMP on COX-2 expression in SK-N-SH human neuroblastoma cells. Exposure to BIMP changed cell morphology and induced caspase-dependent apoptotic cell death accompanied by cleavage of caspase 3, caspase 9, and poly (ADP-ribose) polymerase (PARP)...
March 2016: Hiroshima Journal of Medical Sciences
Takashi Nonoshita, Shinya Otsuka, Masaru Inagaki, Hiromi Iwagaki
A 58-year-old woman with advanced gastric cancer underwent total gastrectomy in May 2012. The histological diagnosis was poorly differentiated adenocarcinoma, cT4a (SE), pN1, cM0; fStage IIIA. Chemotherapy by S-1 was started after surgery. Six months after the operation, two metastatic nodules were noticed on the liver. Therefore, the chemotherapy was switched to S-1 plus cisplatin (CDDP) in November 2012. TS-1 (80 mg/body) was administrated from day 1 to 21 followed by 14 days rest as one course. CDDP (70 mg/body) was infused on day 1...
December 2015: Hiroshima Journal of Medical Sciences
Prasanna Karki, Hirofumi Hirano, Hitoshi Yamahata, Shingo Fujio, Hajime Yonezawa, Koji Iida, Manoj Bohara, Tatsuki Oyoship, Ryosuke Hanaya, Kazunori Arita
Langerhans cell histiocytosis (LCH) is a proliferation of Langerhans cells intermixed with inflammatory cells, in particular eosinophils, that may manifest as a unisystem (unifocal or multifocal) or multisystem disease. We describe the clinical and histologic spectrum of LCH of the orbit and skull in our two cases. Both cases had unifocal erosive skull lesions with a history of trauma. Typical histologic features included numerous histiocytes with varying degrees of giant cell formation and scattered eosinophilic granulocytes...
December 2015: Hiroshima Journal of Medical Sciences
Daisuke Komoto, Koji Iida, Toru Higaki, Yoko Kaichi, Komei Takauchi, Koji Arihiro, Akiyoshi Kakita, Yutaka Hirokawa, Kazuo Awai
To compare the diagnostic performance of 18F-FDG PET, 11C-FMZ PET, and 11C-FMZ BP imaging for the evaluation of patients with intractable partial epilepsy whose MRI findings are normal by using statistical imaging analysis. Ten patients underwent comprehensive presurgical evaluation, including PET studies, to assess the epileptic foci. The extent of cortical resection was based on the results of intracranial video-electroencephalography (IVEEG) monitoring and brain mapping under stimulation. The images of 10 patients and 30 controls were spatially normalized to templates generated in-house by non-rigid registration and the standardized images of the patients and controls were statistically compared...
December 2015: Hiroshima Journal of Medical Sciences
Takuya Sakoda, Yoshiaki Murakami, Naru Kondo, Kenichiro Uemura, Yasushi Hashimoto, Naoya Nakagawa, Taijiro Sueda
Mirizzi syndrome is a rare complication of cholelithiasis, which is defined as a common bile duct obstruction due to stones impacted in Hartman's pouch or the cystic duct of the gallbladder. The impacted stones and surrounding inflammation can lead to a biliobiliary fistula. We herein present the case of a 73-year-old Japanese man with a biliobiliary fistula that was diagnosed by peroral cholangiography (POCS). We performed partial cholecystectomy and choledochoplasty as the stone had eroded almost the entire circumference of the bile duct...
September 2015: Hiroshima Journal of Medical Sciences
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