A 58-year-old Japanese woman complained of unstable gait and dizziness lasting for a month. She had been diagnosed histologically with pulmonary and cutaneous sarcoidosis and attended outpatient ...clinics for routine checkups. Head computed tomography and magnetic resonance imaging (MRI) indicated obstructive hydrocephalus caused by a contrast-enhanced lesion in the cerebral aqueduct. The patient underwent endoscopic third ventriculostomy and a biopsy of the lesion, leading to the diagnosis of neurosarcoidosis. This was a rare case of neurosarcoidosis presenting with obstructive hydrocephalus that was treated with endoscopic third ventriculostomy and diagnosed histologically via an intraoperative biopsy.
Recently, the focus has been on the importance of assessing the oral disintegrative properties of orally disintegrating tablets (ODTs). In particular, in the development stages and the quality ...control field of ODT products, a physical assessment method which easily measures oral disintegrative properties is desired. For this reason, we developed a new disintegration test method (Kyoto-model disintegration method or KYO method), which is useful to predict the oral disintegrative properties of an ODT easily, and examined the availability of the method. In the KYO method, ODT samples were classified in terms of their water permeability, and a moderate water volume was decided. Subsequently, the disintegrative properties were assessed with the newly proposed method. For 25 commercial prescription ODTs used as samples, a good correlation was shown between the results of a human sensory test by five healthy male volunteers and the results using the KYO method. Furthermore, the KYO method could evaluate time-dependent changes in ODT samples. On the other hand, no correlation was observed between the Japanese Pharmacopeia disintegration test and the human sensory test. These results suggested that the KYO method reflected the disintegration nature of the ODTs in the oral cavity, and could easily be applied to development stages and the quality control field of ODT products.
A 59-year-old woman was admitted for acute pancreatitis. Abdominal computed tomography and magnetic resonance imaging revealed a swollen pancreatic parenchyma with dilatation of the main pancreatic ...duct (MPD) of the pancreas tail, which was separated from the normal pancreas body side by a locally atrophic part of the pancreas. Magnetic resonance cholangiopancreatography showed MPD stricture in the pancreas tail with dilatation of the upstream MPD. Endoscopic ultrasonography revealed that the MPD stricture of the pancreas tail was surrounded by a blurred and hypoechoic area. Endoscopic retrograde cholangiopancreatography was performed for serial pancreatic-juice aspiration cytologic examination (SPACE). The result indicated adenocarcinoma. Distal pancreatectomy was performed, and the histopathological examination showed high-grade PanIN (carcinoma in situ of the pancreatic duct) of the pancreas tail with atrophy and fibrosis of the pancreatic parenchyma, and local fat replacement adjacent to the lesion. The final histopathological diagnosis was carcinoma in situ of the pancreatic duct of the pancreas tail. Acute pancreatitis and local fatty change of the pancreatic parenchyma with MPD stricture are important clinical manifestations of pancreatic carcinoma in situ (PCIS) and performing SPACE in cases of MPD stricture without a recognizable mass is preferable for a diagnosis of PCIS.
A sensitive and specific method using high-performance liquid chromatography (LC)–electrospray tandem mass spectrometry (ESI–MS/MS) for the determination of indapamide in human serum was developed ...and validated. Indapamide and an internal standard (4-diethylaminobenzoic acid) were isolated from serum samples by solid-phase extraction (SPE) with Oasis
®HLB 96-well plates and determined by LC–MS/MS in multiple reaction monitoring (MRM) mode. The calibration curve of serum indapamide was linear in the range of 0.2–20
ng/ml with a correlation coefficient of 0.9999. The repeatability, intermediate precisions, and accuracies at 0.2, 5, and 20
ng/ml in serum were less than 15%. The absolute recoveries of indapamide and the internal standard were 79.4–81.5% and 87.5%, respectively, and the low limit of quantitation of serum indapamide was 0.2
ng/mL. The analytical method was applied to a bioequivalence study of KYD-041 (1
mg as film-coated tablets, test formulations) and Natrix
®Tab.1 (1
mg as sugar-coated tablets, reference formulation). The 90% confidence interval of the ratios (test formulation/reference formulation) for log(
C
max) and log(AUC
t) were in the range log(0.80)–log(1.25), which supports the conclusion that KYD-041 is bioequivalent to Natrix
®Tab.1 with respect to the rate and extent of indapamide absorption.
We experienced two patients with an intraductal papillary mucinous neoplasm (IPMN) suffering from suppurative pancreatic ductitis (SPD), which presented with abdominal pain and fever with elevated ...inflammatory reactions. One of the two patients with a main duct type suffered from SPD two days after transpapillary pancreatic duct biopsy, which was relieved mainly with transpapillary mucin extraction. The patient underwent distal pancreatectomy but died from an iliopsoas muscle abscess on the 35th post-operative day. In another patient with a branch duct type at the head, SPD occurred 9 days after pancreatic juice cytology and was treated with antibiotics administration.
A case report.
To understand a rare case of ligamentum flavum progressive hematoma.
Previously there were only two reports about ligamentum flavum hematoma.
A patient was surgically treated for ...ligamentum flavum hematoma causing progressive L5 radiculopathy. Clinical and neuroradiologic features were reported, and the literature was reviewed.
The etiology of this case could not be defined except by minor back injury. In spite of conservative therapy, the symptoms were progressive for 7 months. Magnetic resonance imaging demonstrated the epidural mass lesion at L4-L5 that was continuous with the ligamentum flavum. The mass was hypointense in T1-weighted images and central hyperintense and marginal hypointense in T2-weighted images. The margin was well enhanced by Gd-DTPA administration. After removal of the mass lesion, the patient's symptoms completely resolved. Before surgery, accurate diagnosis was difficult even based on magnetic resonance imaging and was achieved after histologic examinations.
Surgery could be a choice of the treatment modality to resolve symptoms in ligamentum flavum hematoma.
Key Message
Classically, metastatic tumours are solid, multiple, well‐circumscribed, and rarely cavitary. This rare case of metastatic pulmonary malignant melanoma showed a ring‐shaped ground‐glass ...opacity and then the halo sign, depending on the disease progression.
Classically, metastatic tumours are solid, multiple, well‐circumscribed, and rarely cavitary. This rare case of metastatic pulmonary malignant melanoma showed a ring‐shaped ground‐glass opacity and then the halo sign depending on the disease progression.
A case of a lymphangioma of the jejunal mesentery WATANABE, Takahiro; OHATA, Kou; SATO, Shinsuke ...
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association),
2012, 2012-00-00, Volume:
73, Issue:
8
Journal Article
Open access
We report a case of a lymphangioma of the jejunum which was surgically resected. The case involved a 16-year-old male who had realized a sense of abdominal distension for the past 5 years. He visited ...a hospital because of a 2-week history of abdominal pain and ultrasound examination revealed an abdominal tumor. He was referred to our hospital. Abdominal CT scan and MRI showed a multilocular cystic mass, about 13cm in longer diameter, without enhancement effect at the midline of the abdominal cavity and the mass had fluid-fluid level formed by high and low density components. We diagnosed the mass as mesenteric lymphangioma with repeated bleeding and performed operation. On laparotomy, the 10-cm diameter mass was found in the mesentery of the jejunum near the ligament of Treitz and was resected with a part of the jejunum close to the mass. The histopathological diagnosis was lymphangioma of the jejunal mesentery. Lymphangioma of the jejunal mesentery is relatively rare. We review 30 cases reported in Japan, including this case.
A 65-year-old woman who had been diagnosed with dermatomyositis presented to the hospital with a small bowel mass. She had tested positive for fecal occult blood test and anemia at a medical ...checkup;therefore, computerized tomography (CT) was performed at the previous hospital and it had revealed thickening of the intestinal wall. Abdominal contrast-enhanced CT, single-balloon assisted enteroscopy, and biopsy led to a diagnosis of poorly differentiated jejunal adenocarcinoma. The patient underwent laparoscopic segmental resection of the jejunum with dissection of mesenteric lymph nodes. A histological examination revealed that the tumor was neuroendocrine carcinoma (NEC), large-cell type of the jejunum, pT3, pN0, sM0, and pStage IIA. Immunohistochemically, the NEC component was positive for chromogranin A and negative for neural cell adhesion molecule and synaptophysin. The MIB-1 index was 60%. Four courses of postoperative chemotherapy using cisplatin and etoposide were administered. The patient is currently doing well without any recurrence or metastasis. To the best of the author's knowledge, this is the first report of dermatomyositis associated with primary jejunal NEC.
PDF
