Hepatic portal venous gas disappearing within 24 hours

Hepatic portal venous gas (HPVG) was detected by CT in a 64-year-old woman who suddenly complained of lower abdominal pain. However, the abdominal symptoms disappeared rapidly, and lower gastrointestinal endoscopy indicated only terminal ileitis. Conservative treatment alone was performed, and HPVG completely disappeared approximately 18 hours later. The use of CT proved to be useful for following the course of HPVG.     

The effect of paroxetine on Taijinkyofusho: a report of three cases

Taijinkyofusho is a culture-related syndrome conceptualized in Japan. While previous studies suggest its psychopathological similarities to social phobia and obsessive-compulsive disorder, introspection regarding shame and low self-esteem is particularly linked to Japanese culture. We present three cases of Taijinkyofusho: Cases 1 and 2 show neurotic features while Case 3 shows delusional thoughts. Paroxetine was used for treatment but was productive in only the first two cases. Phobic and obsessive thought patterns were altered in Cases 1 and 2, suggesting that the significant core symptoms were responding to the treatment. In the future, large-scale pharmacological studies will be necessary to investigate treatment outcomes Taijinkyofusho. Such studies would contribute to providing information for effective treatment as well as for examining relationships between Taijinkyofusho and related disorders.     

The significance of tumour markers as an indication for mediastinoscopy in non-small cell lung cancer

OBJECTIVE: The purpose of this study was to verify the significance of tumour markers as indicators for mediastinoscopy in non-small cell lung cancer. METHODOLOGY: In the past 4 years, 205 patients with non-small cell lung carcinoma (NSCLC) underwent surgical resection at Chiba Cancer Center, Chiba, Japan. The correlation between the serum levels of eight tumour markers (CEA, AFP, CA19-9, SCC, NSE, CA125, CYFRA, ProGRP) and the presence of N2 disease was analysed. Univariate and multivariate analyses were performed to determine the relationship between both marker levels and clinical findings and N2 disease. RESULTS: In multivariate analysis, positive CEA was significantly associated with the diagnosis of N2 disease. We also demonstrated that when CA125, CYFRA and ProGRP were positive, they were individually significantly associated with N2 disease. However, CEA was superior to the other markers and equivalent to a combination of various tumour markers. CONCLUSION: It was concluded that evaluation of CEA in addition to CT is of use in the diagnosis of N2 disease in NSCLC patients and should be used as an indication for mediastinoscopy.     

Using an air-pad sensor for the diagnosis of sleep apnea: a trial study

An air-pad sensor (APS) was developed to record respiratory effort non-invasively. The APS is placed under the subjects' bodies and acoustic signals received by the pad are analysed. Nine patients with obstructive sleep apnea (OSA) and two healthy subjects were examined using an APS and daytime polysomnography, including intraesophageal pressure (Peso), simultaneously. The agreement ratio in terms of the central apnea time between the APS and the Peso was 93.4%, although the ratio between the Peso and an abdominal strain gauge was 40.7%. The agreement ratio in terms of respiratory rate among the Peso, APS, and abdominal strain gauge in patients with OSA was high; but the agreement ratio was low (74.4%) between the Peso and the strain gauge in mixed apnea.     

Mental health issues of peacekeeping workers

The end of the Cold War has brought a dramatic change to the international political situation and the role of the United Nations peacekeeping operations (PKO) has drawn increased attention. While many reports on PKO have focused on political or sociologic considerations, the mental health of the peacekeepers themselves has received little attention and psychiatric problems that can have a negative impact on mission success have been largely ignored. Participation in PKO creates a number of stressors and serious psychiatric and/or physical disorders may result. Yet, there is little research on this topic, either domestically or globally, and the methodology for clinical intervention remains in an early stage of development. We have reviewed previous reports to determine how various stressors before, during and after deployment affect the participants. Research in associated fields (e.g. crisis workers and military personnel) are also reviewed and their application to peacekeeping psychiatry is discussed. It must be admitted that the significance of PKO is arguable and each PKO is unique in terms of the nature of its mission and the local situation. Yet, the relationship between the psychiatric status of the personnel and the characteristics of an individual mission has never been studied. At present, no clear consensus regarding a framework for psychiatric intervention exists. Studies that enhance the recognition and significance of peacekeeping psychiatry are likely to improve the efficacy of PKO.     

A graft-versus-tumor effect in a patient with ependymoma who received an allogenic bone marrow transplant for therapy-related leukemia. Case report

Graft-versus-leukemia effect is an immune-mediated antitumor phenomenon associated with allogenic bone marrow transplants (BMTs) for hematological malignancies, and recent findings have indicated that a similar effect could occur in some solid tumors such as breast cancers. The authors report on a 42-year-old man with a recurrent ependymoma who received an allogenic BMT for therapy-related leukemia. After transplantation, the patient developed chronic graft-versus-host disease, which was controlled with steroid agents. Interestingly, the recurrent ependymoma regressed steadily over the next 21 months posttransplant, until the tumor became almost undetectable on magnetic resonance images. This case indicates that the graft-versus-tumor effect, mediated by cytotoxic T cells, may be able to target intraparenchymal neuroepithelial tumors, despite the brain's generally recognized status as an immunoprivileged organ.     

Spontaneous regression of bone metastasis from renal cell carcinoma; A case report

Background  

Spontaneous regression of metastatic renal cell carcinoma is rarely observed.