STANDARD IMAGING TECHNIQUES OF ENDOSCOPIC ULTRASOUND‐GUIDED FINE‐NEEDLE ASPIRATION USING A CURVED LINEAR ARRAY ECHOENDOSCOPE

Standard imaging techniques using a curved linear array echoendocope are summarized to facilitate the attainment of expertise in endoscopic ultrasonography and endoscopic ultrasound‐guided fine needle aspiration, and to promote the widespread use of this diagnostic and therapeutic tool. Typical images of the mediastinal organs, the bilio‐pancreatic systems and neighboring organs by scanning from the esophagus, stomach, duodenal bulb, and descending portion of the duodenum, are shown in a sequential manner. The basic techniques of endoscopic ultrasound‐guided fine needle aspiration are also presented.     

Challenges for nephrology nurses in the management of children with chronic kidney disease.

An important treatment goal for pediatric nephrology caregivers is the optimization of a child's capacity for normal growth and development. However, the physiologic and metabolic derangements associated with chronic kidney disease (CKD) significantly alter these processes, creating important challenges in the care of affected children. Evidence-based clinical practice guidelines support early recognition and treatment of CKD-related complications to improve growth and development and, ultimately, quality of life for children with this chronic condition.     

Metastatic penile tumor from lower pharynx: a case report

Metastatic tumor of the penis is uncommon and only 95 cases have been reported in Japan. A 70-year-old man, who had squamous cell carcinoma of the lower pharynx, complained of urethral induration. Biopsy was performed and pathological diagnosis was metastatic tumor of penis originating from the lower pharynx. Although partial response in tumor size was noted by irradiation therapy, the patient died of multiple metastases in the 4th month after the diagnosis. This case is the first report of metastatic penile tumor originating from the lower pharynx.     

Adolescence Mycosis Fungoides: An Unusual Presentation with Hypopigmentation

Mycosis fungoides (M.F.) is a rare cutaneous malignancy of childhood and adolescence. The disease commonly presents with the classic sequence of erythematous patches and plaques. Hypopigmentation as the presenting symptom is distinctly rare. This is the 9th case report of M.F. presenting with hypopigmentation in a patient under 20 years of age. The disease was only partially controlled with PUVA therapy, necessitating nitrogen mustard treatment.     

Effects of repeated inhalation-exposure to fenitrothion powder on blood cholinesterase activity in rats

Effects of repeated exposure to Fenitrothion (Sumithion) powder on erythrocyte membrane acetylcholinesterase (AChE) and plasma cholinesterase (PChE) were studied. Rats (Wistar, male) were exposed to fenitrothion powder for 2 hrs/day, 5 days/week for up to 3 months. The suppression of AChE and PChE increased as the exposure period and exposure concentration increased, although no suppression of AChE was found after a single 4-hr exposure. The persistence of AChE inhibition after the termination of exposure increased with the increase of the exposure period and was longer than that of PChE. Therefore, the AChE activity seems to be useful in examining the response to the repeated exposure to fenitrothion powder.     

Histopathological observations on orbital fatty tissue in dysthyroid ophthalmopathy

Seventeen specimens of orbital fatty tissue taken from cases of dysthyroid ophthalmopathy at the time of operation were observed by light and electron microscopy, and also by immunohistochemical staining. The pathological changes observed were infiltration of the chronic inflammatory cells, deposit of fibrin, sclerosis of vascular wall, occlusion of the vascular lumen, and accumulation of hydrophilic mucopolysaccharide. Immunoglobulin G was detected in fat cells and lymphocytes, and some of the infiltrating lymphocytes were determined to be T cells, by immunohistochemistry. These findings suggested that the pathology of the dysthyroid ophthalmopathy was closely related to the chronic inflammation induced by the immune reaction. The exophthalmos was considered to occur due to edema secondary to chronic inflammation and accumulation of the mucopolysaccharides.     

Sisters with mercury exposure

The same iron pot in which their father had boiled lead with mercury (from a glass thermometer) for the purpose of alchemy, was also used for cooking in the kitchen. Although his wife had died of mercury poisoning, and his 14-year-old and 11-year-old daughters were found to excrete 322 and 455 micrograms/l mercury in the urine, respectively, (1-10 micrograms/l in controls), he stubbornly refused to give permission for them to be examined further. Nine months later, the daughters were permitted to be sent to our clinical ward. While the blood level of mercury had already come down to near normal, its excessive deposition in hair, kidneys and other parts of the body as well as its excessive urinary excretion, were still persistent (beyond tenfold the normal). According to our measurement values, mercury ranged from 14 to 49 micrograms/g in every 1-cm-piece of 10 cm hair of the elder sister, and ranged from 21 to 85 micrograms/g in 14 cm hair from the younger sister. About a 75% decrease in mercury deposition was estimated during these 9 months, based on the speculation of 1.5 cm/month hair-lengthening.