Extraosseous myelomatosis Clinical presentation with symptoms in Lower urinary tract

We believe this to be the first case reported of extraosseous myelomatosis seen clinically with lower urinary tract symptoms. Extraskeletal spread of myelomatosis which reportedly occurs in two thirds of cases is discovered postmortem. Immunoglobulin A prevails in this type of myelomatosis. Clinical course and autopsy findings are discussed.     

Delayed Fracture Healing in Aged Senescence-Accelerated P6 Mice

ABSTRACT

Background: Osteoporosis is characterized by poor bone quality. However, it is still controversially discussed whether osteoporosis compromises fracture healing. Herein, we studied whether the course of healing of a femur fracture is affected by osteoporosis or age. Methods: Using the senescence-accelerated osteoporotic mouse, strain P6 (SAMP6), and a closed femur fracture model, we studied the process of fracture healing in 5- and 10-month-old animals, including biomechanical, histomorphometric, and protein biochemical analysis. Results: In five-month-old osteoporotic SAMP6 mice, bending stiffness, callus size, and callus tissue distribution as well as the concentrations of the bone formation marker osteocalcin and the bone resorption markers tartrate-resistant acid phosphatase form 5b (TRAP) and deoxypyridinoline (DPD) did not differ from that of non-osteoporotic, senescence-resistant, strain 1 (SAMR1) controls. In contrast, femur fractures in 10-month-old SAMP6 mice showed a significantly reduced bending stiffness and an increased callus size compared to fractures in age-matched SAMR1 controls. This indicates a delayed fracture healing in advanced age SAMP6 mice. The delay of fracture healing was associated with higher concentrations of TRAP and DPD. Significant differences in osteocalcin concentrations were not found between SAMP6 animals and SAMR1 controls. Conclusion: In conclusion, the present study indicates that fracture healing in osteoporotic SAMP6 mice is not affected in five-month-old animals, but delayed in animals with an age of 10 months. This is most probably due to the increased osteoclast activity in advanced age SAMP6 animals.     

Surgical experience of 6 multiple primary lung cancers

Recently, we often meet multiple primary lung cancers with ground glass opacity (GGO). It is necessary for us to find suitable strategy to each case. We report a rare case with 6 lesions all of which were resected surgically. A 60-year old male visited our hospital for examination of abnormal shadows on the chest X-ray. Computed tomography (CT) scan showed 5 GGO lesions in the lung field (2 in the left lower lobe, 2 in the right upper lobe, 1 in the right middle lobe). He underwent left S6 segmentectomy as a 1st surgery, followed by wedge resection of the right upper lobe with right middle as a 2nd surgery. Pathologically, they were type A and B of the Noguchi classification. After 3-year follow-up, a new lesion developed in the right lower lobe and was resected by right lower lobectomy. It was invasive papillary adenocarcinoma. As a consequence, 6 lesions were all removed safely. The patient has been well without recurrence for 1 year after the last surgery.