Malignant rhabdoid tumor of the liver: a case report with US and CT manifestation

A case of malignant rhabdoid tumor (MRT) of the liver in a 4-month-old boy with hepatomegaly was described with the help of US and CT findings. The boy had multiple liver tumors, and the liver parenchyma showed a diffuse heterogeneous appearance. Lymph node swelling was noted, although the alpha-fetoprotein concentration was not elevated. A diagnosis of MRT was confirmed pathologically. Twenty-seven cases of MRT of the liver with solitary tumors, multiple tumors, or diffuse infiltration have been reported in the English-language literature. Diagnostic imaging plays an important role in detecting metastasis because of the high frequency of distant metastasis in MRT of the liver.     

Relationship of Daily Coffee Intake with Vascular Function in Patients with Hypertension

We evaluated the relationship of daily coffee intake with endothelial function assessed by flow-mediated vasodilation and vascular smooth muscle function assessed by nitroglycerine-induced vasodilation in patients with hypertension. A total of 462 patients with hypertension were enrolled in this cross-sectional study. First, we divided the subjects into two groups based on information on daily coffee intake: no coffee group and coffee group. The median coffee intake was two cups per day in the coffee group. There were significant differences in both flow-mediated vasodilation (2.6 ± 2.8% in the no coffee group vs. 3.3 ± 2.9% in the coffee group, p = 0.04) and nitroglycerine-induced vasodilation (9.6 ± 5.5% in the no coffee group vs. 11.3 ± 5.4% in the coffee group, p = 0.02) between the two groups. After adjustment for confounding factors, the odds ratio for endothelial dysfunction (OR: 0.55, 95% CI: 0.32–0.95) and the odds ratio for vascular smooth muscle dysfunction (OR: 0.50, 95% CI: 0.28–0.89) were significantly lower in the coffee group than in the no coffee group. Next, we assessed the relationship of the amount of daily coffee intake with vascular function. Cubic spline curves revealed that patients with hypertension who drank half a cup to 2.5 cups of coffee per day had lower odds ratios for endothelial dysfunction assessed by flow-mediated vasodilation and vascular smooth muscle dysfunction assessed by nitroglycerine-induced vasodilation. Appropriate daily coffee intake might have beneficial effects on endothelial function and vascular smooth muscle function in patients with hypertension.     

A New Method for the Detection of Air Leaks Using Aerosolized Indocyanine Green

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In vivo production of heat shock protein in mouse peritoneal macrophages by administration of lipopolysaccharide.

The in vivo production of heat shock protein was studied by administration of bacterial lipopolysaccharide (LPS) into mice. Heat shock protein 70 was detected in the extract of adherent peritoneal cells from mice injected intraperitoneally with LPS by using the immunoblotting method. The expression of heat shock protein 70 was found 2 days after injection of LPS and reached its peak 4 days after injection. The intraperitoneal injection of LPS induced the expression of heat shock protein 70, whereas its subcutaneous injection did not. The in vivo production of heat shock protein 70 was inhibited by administration of LPS together with quercetin, an inhibitor of accumulation of heat shock protein 70 mRNA. Tumor necrosis factor alpha enhanced LPS-induced heat shock protein production in vivo. There was a decrease of gamma delta T cells in the peritoneal cavity of mice injected intraperitoneally with LPS. It was suggested that bacterial LPS is a stressful agent which induces the in vivo heat shock protein response, and its administration leads to the production of heat shock protein 70 in peritoneal macrophages.     

A case of ataxic diplegia, mental retardation, congenital nystagmus and abnormal auditory brain stem responses showing only waves I and II

A three-year-old boy who had ataxic diplegia, mental retardation, horizontal pendular nystagmus with head nodding and abnormal auditory brain stem responses showing only waves I and II was presented. His clinical features coincided with recent reports in the Japanese literature of cases of a new syndrome that is congenital in origin and seen only in boys.     

Balloon valvuloplasty for pulmonary valvular stenosis: a long-term follow-up study using pulsed Doppler echocardiography

From June 1984 to March 1987, percutaneous balloon valvuloplasty (PBV) was performed for 22 patients with congenital pulmonary valvular stenosis. It was successful for 20 patients, and there were significant decreases of transvalvular pressure gradients; 72 +/- 30 mmHg before PBV, and 30 +/- 12 mmHg immediately after PBV (p less than 0.001). In a follow-up study, pulsed Doppler echocardiography and cardiac catheterization were used to examine changes in long-term hemodynamic findings after PBV. One year follow-up evaluation was performed for 14 patients, and two year follow-ups for seven patients. One year after PBV the transvalvular pressure gradients were evaluated during cardiac catheterization in 11 patients, and using pulsed Doppler echocardiography in the remaining three patients. The gradients of the seven patients at two year intervals after PBV were evaluated using pulsed Doppler echocardiography. The pressure gradients of two patients improved further one year later due to the anatomical degradation in the right ventricular outflow tracts. For seven patients, two year follow-up evaluations were performed, and the transvalvular pressure gradient reduced from 84 +/- 23 to 33 +/- 15 mmHg (p less than 0.001) immediately afterwards; to 27 +/- 22 mmHg (p less than 0.01) one year later; and further to 12 +/- 5 mmHg (p less than 0.001) two years after PBV. Second PBV was performed for three patients in whom a residual gradient was recognized, with the good results. On auscultation, a pulmonary regurgitant murmur was recognized in 28% of 18 patients immediately after PBV, but 80% of this resolved one year later. Two patients had pulmonary regurgitation with pulmonary valvular stenosis before PBV.(ABSTRACT TRUNCATED AT 250 WORDS)     

Neonatal cerebral infarction: symptoms, CT findings and prognosis.

In a retrospective multi-center study, we investigated eighteen infants with unilateral cerebral infarctions confirmed by computed tomography (CT) scans. The initial symptoms were observed in all the patients between 0 and 3 days of age. Convulsions or apneic attacks were the initial symptoms in all but one. Only 4 patients had complicated obstetric histories and none showed polycythemia or electrolyte abnormalities. All of the initial CT scans revealed unilaterally localized hypodense areas. In 10, the initial CT scans were performed within 24 hours after the clinical onset. In 16, the lesions were within the territory of the middle cerebral artery, 9 of which also involved the cortico-spinal tract (CST). In the remaining 2 patients, the lesions were located within the territory of the posterior cerebral artery. None of the 9 patients without CST involvement developed hemiplegia, whereas 5 (56%) of the 9 with CST involvement had hemiplegia, which is a fairly low incidence compared with that in adult cases. This difference was thought to be related to neonatal brain plasticity.     

Infective endocarditis in children: a current diagnostic trend and the embolic complications

Twenty-three cases of IE, of which 91% had underlying congenital heart diseases were diagnosed by positive blood culture or vegetative lesion detected by 2-D ECHO when a patient revealed clinically suspicious episodes. VSD and TOF were the most common underlying heart diseases. The vegetation was detected successfully by 2-D ECHO in 91% of the cases. The causative organisms were identified in 83% of the cases. Streptococcus viridans and Staphylococcus aureus were the two major organisms detected. Candida albicans was found in 3 postoperative and fatal cases. Embolic complications occurred in 7 cases (30.5%): five cases of pulmonary infarction and two of cerebral infarction. The overall mortality was 22%. We recommend early surgical intervention whenever a patient reveals a very large vegetation with animated movability, and emphasize the importance of a proper prophylaxic regimen.