Expandable metallic stent for the treatment of left-sided colonic obstruction with malignant disease

Recently, it was reported that an EMS (expandable metallic stent) was useful for treatment of colorectal obstruction. In our department, EMSs were used for seven patients with left-sided colonic obstruction with unresectable malignant disease. After these treatments with EMS, their symptoms were improved and they were able to intake food. Stomal formation was avoided except in one patient with severe soiling. In conclusion, EMS is thought to be useful for the improvement of quality of life in the patients with unresectable malignant colonic obstruction.     

Interventricular methotrexate therapy for carcinomatous meningitis due to breast cancer: a case with leukoencephalopathy

A 46-year-old woman presented with paraplegia and severe lumbago. She had had a radical mastectomy for left breast cancer 10 years earlier, and 6 months prior to presentation she completed CMF chemotherapy for treatment of retroperitoneal metastasis. CT and MRI to identify potential causes of the paraplegia and lumbago showed leptomeningeal carcinomatosis due to dissemination from invasive recurrence of the retroperitoneal tumor. An Ommaya reservoir was inserted, and infusion of intrathecal methotrexate (MTX; 5 mg twice weekly) began. Her clinical symptoms improved after receiving 53 mg MTX. However, after receiving 83 mg MTX, the patient became dizzy from leukoencephalopathy. Although administration of prednisolone mostly resolved her symptom, the patient died 9 months after the diagnosis of carcinomatous meningitis.     

Required thermal environments for the quadriplegic persons: Analyses of questionnaires and experiments on their daily life

A physically disabled person often has additional disabilities on adaptation to the thermal environment. Since 1976, our group has carried out a series of studies to find required thermal conditions for disabled persons on several typical disabilities. This paper reports on the results of our latest questionnaire and experiments on daily thermal environment for quadriplegic persons. Among 292 quadriplegic persons with valid questionnaire, 184 (63%) were fully paralyzed. Nearly 90% of these and 60% of partially paralyzed patients were dissatisfied with the thermal environment and sweating. Several suggestive differences were found according to the broken positions of vertebrae. The results of 48 hours of field measurements on three quadriplegic subjects are compared with those obtained from questionnaire.     

Fournier's Gangrene: Report of a Case Associated with Paralytic and Mechanical Ileus throughout the Management of the Gangrene

A 65-year-old Japanese male, who was treated for Fournier's gangrene, developed an enlarged erythema over the right thigh and right lower quadrant. The area was surgically debrided, and he was given antibiotics. However, he complained of abdominal swelling with a metallic bowel sound, pain, and vomiting and was then treated for paralytic ileus. Although his symptoms initially improved, he complained again of the same symptoms and underwent surgery for mechanical ileus occurring at the site of a surgical scar from an appendectomy 43 years earlier. This is a very rare case of Fournier's gangrene which caused mechanical ileus of the small intestine and adherence to a peritoneal scar after paralytic ileus due to inflammation of the abdominal fascia following scrotal gangrene.     

Adult adrenal neuroblastoma with extension into inferior vena cava

An adult left adrenal neuroblastoma that extended into the left renal vein and inferior vena cava is reported. To the best of our knowledge, venous involvement of adrenal tumors has been reported in adrenal cortical carcinomas, but not in neuroblastomas. Differentiation of renal and adrenal tumors is also discussed.     

Effect of the combination of voluntary exercise and dietary protein levels on the deposition of glycogen, liver and serum lipids in mice.

The effects of voluntary exercise on the growth, glycogen of muscle and lipid contents of the liver and serum of mice fed different levels of dietary protein were investigated. In both the exercise and non-exercise groups, body weight gains were significantly greater in the 20% and 30% protein diet groups than in the 6% and 4% protein diet groups. After 6 weeks of age, it was shown that the amount of voluntary exercise by the 6% and 4% protein diet groups was greater than that by the 20% and 30% protein diet groups. As for hematological status, the raising of hemoglobin levels due to increasing dietary protein levels was further exaggerated by voluntary exercise. Hematocrit values rose with the increase in dietary protein levels. However the effect of exercise on hematocrit values was not clear. Liver glycogen levels, which were elevated with the increase in dietary protein levels, rose further due to exercise, though no changes were observed in muscle glycogen due to dietary protein levels and exercise. The lipid contents of the liver in all groups tended to be lower in exercise groups compared with non-exercise groups and it was observed that the high levels of dietary protein depressed the increase in liver lipids. Liver triglyceride levels of all groups fed the dietary protein levels except for the 20% casein diet group decreased due to voluntary exercise, and liver triglyceride levels were also lowered as dietary protein levels increased. The levels of serum triglyceride of all groups decreased due to voluntary exercise. This phenomenon was most remarkable in rats fed a 6% casein diet. The tendency for serum cholesterol levels to decrease due to exercise. However it was not further influenced by voluntary exercise in the 4% casein diet group.