Multicentric liposarcoma

Abstract A 72-year-old man complaining of upper abdominal discomfort was diagnosed as having retroperitoneal liposarcoma by means of diagnostic imaging. He then underwent an operation. One mass existed on the curvatura ventriculi major, extending to the hilum splenicum and pressing back the pancreal head and body. There was another mass to the left of the first, situated on the ventral side of the left kidney. Also, another mass was intramurally found adjacent to the curvatura ventriculi major. Histologically, the mass on the curvatura ventriculi major ranged from the peritoneal cavity to the retroperitoneum Its intraperitoneal portion was classified as a differentiated lipoma-like type and the retroperitoneal mass was of mucous type. The mass on the left kidney was of a differentiated fibrosing type. The intramural mass in the gastric curvature was found to be a differentiated lipoma-like type. The patient has been under observation for 12 months and has shown no recurrence.     

Video analysis of gross body movements during sleep

Abstract Gross body movements (GM) during sleep, classified into four GM types by the involved parts of body, were evaluated using two-dimensional video analysis in five normal children aged 4–12 years. The rate of occurrence of all GM types showed apparent sleep stage dependency. Among four GM types, GM-1 (GM with axial rotation) was the most frequent. Averaged duration of GM-1 was the longest. A total of 77.2% of GM-1 started with the contraction of chin muscle and 35% of total sleep changes (tSC) were related to GM. A total of 5.6% of tSC following GM shifted to the deeper stage. Further evaluation is necessary in order to understand the physiological mechanism of GM.     

慢性乙型肝炎患者肝组织内CD4+CD25+Foxp3+调节性细胞的作用

目的 观察慢性乙型肝炎患者肝内调节性T细胞(Treg)与病情活动、肝细胞损伤的关系.方法 对日本长崎大学医学院附属医齿学病院第一内科26例住院慢性乙型肝炎患者进行肝组织活检,采用免疫组织化学方法以单抗Foxp3、单抗CD3检测肝组织内Foxp3+细胞和CD3+细胞频率,计算Foxp3+/CD3+细胞比率,结合肝组织学炎症活动指数(HAI,采用Knodell评分系统)、ALT、AST、HBV DNA水平进行分析.数据用SPSS 13.0软件进行统计分析.结果 Foxp3+Treg主要分布在门脉区;Foxp3+/CD3+细胞(%)在肝实质重度炎症组明显高于轻度炎症组(P=0.007 6);Foxp3+/CD3+细胞(%)的增高与血清ALT、AST水平呈正相关,相关系数分别0.438、0.436(P值分别为0.025、0.026),与血清HBV DNA水平有相关趋势,但差异无统计学意义.结论 CD4+CD25+Foxp3+Treg在慢性乙型肝炎患者的发病机制中参与肝细胞的免疫损伤.     

Echo-Doppler measurements of portal vein and superior mesenteric artery blood flow in humans: Inter- and intra-observer short-term reproducibility

The reproducibility of echo-Doppler measurements of portal vein and superior mesenteric artery blood flow has not been extensively studied. In the present study, two groups of subjects were examined to test inter- and intra-observer reproducibility. Each study population consisted of 15 non-portal hypertensive and 15 portal hypertensive subjects. With a standardized technique, the cross-sectional area and velocity of blood flow in the portal vein and superior mesenteric artery were recorded in triplicate by skilled operators. The flow volume of each vessel was calculated by multiplying the cross-sectional area by the velocity of blood flow. The measurements were performed in a blind fashion over a 60 min period. The reproducibility of measurements was assessed by calculation of intraclass correlation coefficients and coefficients of variation. The intra-observer intraclass correlation coefficient was 0.77 for portal vein blood flow and 0.84 for superior mesenteric artery blood flow, suggesting good reproducibility. The intra-observer coefficient of variation was 11 and 9%, respectively. In contrast, the interobserver intraclass correlation coefficient was calculated to be 0.49 for portal blood vein blood flow and 0.57 for superior mesenteric artery blood flow, indicating fair reproducibility. In addition, the interobserver coefficients of variation were calculted to be 20 and 18%, respectively. These data suggest that intra-observer reproducibility in echo-Doppler measurements of portal vein and superior mesenteric artery blood flow is acceptable but inter-observer reproducibility is not. Examination by a single operator, rather than multiple operators, is therefore advisable. Even when measurements are performed by a single investigator an approximate variance of 10% in the measurement in a single subject should be expected.     

Ten cases of congenital urethral stricture in childhood with enuresis

BACKGROUND: To report short-term clinical outcomes of endoscopic correction of congenital urethral stricture in 10 boys who suffer from enuresis resistant to conservative therapy. METHODS: Fifteen boys ranging between 5 and 15 years old consulted our clinics for nocturnal and diurnal enuresis which had not been improved by medication and behavioral therapy. Among them, voiding cystography revealed bulbar narrowing (Cobb's Collar) in 10 cases and vesico-ureteral reflux was found in four cases (seven ureters). Endoscopically, this lesion was recognized as a ring-form stenosis just distal to the urethral sphincter. It was incised with infantile urethrotome. RESULTS: Vesico-ureteral reflux was resolved in four ureters and improved in one. In all cases, daytime enuresis resolved dramatically and night enuresis became controllable. CONCLUSIONS: Boys who suffer from diurnal enuresis should immediately be explored for the existence of congenital urethral stenosis. Early resolution may bring about better urinary behavior.     

A Rare Case of Unilateral Brachymetatarsia of the 2nd Toe

ABSTRACT A rare case of 2nd toe brachymetatarsia is presented. A satisfactory result was achieved with step-osteotomy and bone grafting from the adjacent 3rd metatarsal shaft to the bony defects of the lengthened 2nd metatarsal, and rigid fixation with miniplate. This method of surgical correction is presented in detail with consideration of the surgical indications.     

Power Doppler imaging of hepatic tumours: Differential diagnosis between hepatocellular carcinoma and metastatic adenocarcinoma

We evaluated the usefulness of power Doppler imaging in the differential diagnosis between hepatocellular carcinoma and metastatic adenocarcinoma. Forty-seven patients with hepatocellular carcinoma and 18 patients with metastatic adenocarcinoma were evaluated using power Doppler imaging. The colour signals of hepatic tumours were graded as follows: 1, colour signals only in the marginal area; 2, small dot or dotted line colour signals within the tumours; 3, continuous solid line colour signals within the tumours. The grade 3 colour signals were classified in the following three patterns; winding line pattern, stretched line pattern and mixed pattern. The colour signals of hepatocellular carcinoma were grade 1 in seven patients, grade 2 in 11 and grade 3 in 29. The colour signals of metastatic adenocarcinoma were grade 1 in three patients and grade 3 in 15. Of the 29 hepatocellular carcinoma patients with a grade 3 signal, 26 patients had winding line patterns and three had mixed patterns. Of the 15 metastatic adenocarcinoma patients with a grade 3 signal, 12 patients had stretched line patterns and three had mixed patterns. In conclusion, power Doppler imaging is useful in the differential diagnosis between hepatocellular carcinoma and metastatic adenocarcinoma to evaluate the colour signal pattern within the tumour.