A new method for estimating time since death by analysis of substances deposited on the surface of dental enamel in a body immersed in seawater

International Journal of Legal Medicine - The present investigation was performed with the objective of developing a method to estimate how long a corpse had been immersed in water after death (the...     

Portal hypertension due to hepatic artery-portal vein arteriovenous fistula—A case report

A case of portal hypertension secondary to traumatic hepatoportal arteriovenous fistula with portal fibrosis was successfully treated by ligation of the afferent hepatic arteries which decreased significantly portal pressure and corrected the abnormal blood inflow to the portal vein via A-V fistula resulting in a recovery of the disturbed liver function. Collateral blood supply from the left hepatic artery into the right hepatic lobe was found to be quite satisfactory after the ligation of the hepatic artery. Hemodynamic data and clinical findings of the present case suggest that the mechanism responsible for the portal hypertension is the inflow block resulting from the interruption of portal venous flow by the inflow of arterial blood via A-V fistula and the subsequent increased blood pressure in portal vein radicals.     

A morphological comparison of cervical spondylotic myelopathy: MRI and dissection findings

The number of people with functional disabilities has been increasing with the rapid changes of age structure in the overall population. One of the major causes of disturbances in daily activities is cervical spondylotic myelopathy (CSM). The transverse area and sagittal diameter of the spinal cord measured by MRI is reported to correlate with the clinical manifestations of CSM, the duration of the disease, and the speed of recovery after surgery in patients with CSM. The purpose of this research is to determine the morphological characteristics of CSM as seen in MRI findings including the spinal cord sagittal diameter, transverse diameter, transverse area and flatness ratio. Twenty-eight of several patients with CSM were treated conservatively after carrying out measurements by MRI. In addition, anatomical studies were carried out on the spinal cords after anatomical dissection of the vertebral column in seven cadavers with CSM. These results, when compared with the morphological analysis of the cervical spinal cord, show that there is a correlation between the transverse areas at C4, C5 and C6 levels, as those at every level of the cervical transverse areas of tissue sections in the dissection cadavers were 10-18% smaller than those in the MRI patients. These results should be taken into account for the treatment of CSM patients.     

Magnetic resonance imaging can detect thoracic inflammation due to familial Mediterranean fever

A 32-year-old man presented to our hospital complaining of periodic fever and unilateral chest pain. We suspected that he had familial Mediterranean fever because of his symptoms. Magnetic resonance imaging (MRI) showed an increased intensity within the anterior chest wall, which was consistent with the site of his pain. Genomic analysis showed the patient to be heterozygous for the E148Q/M694I mutation in the MEFV gene, and we diagnosed familial Mediterranean fever. The ability of MRI to detect inflammatory changes could provide useful additional information for evaluating thoracic symptoms in FMF patients, and the detection of inflammatory changes using MRI may aid in early diagnosis, thus contributing to early and adequate treatment.     

CASE OF A MINUTE SESSILE LESION OF THE SIGMOID COLON WITH MASSIVE CANCER INVOLVEMENT IN THE SUBMUCOSAL LAYER

A 53‐year‐old man was referred to our hospital because of the appearance of a positive fecal occult immunological reaction. We found a domed lesion 0.4 cm in diameter in the sigmoid colon. Bleeding spots were observed on the surface of the lesion on endoscopy. We performed endoscopic mucosal resection of the lesion, which was found to contain well‐differentiated adeno‐carcinoma and cancer cells infiltrating to the cut‐end of resected specimen. Laparoscopy‐assisted sigmoidectomy was then performed with dissection of the lymph nodes. The dissected lesion was diagnosed as adenocarcinoma with moderate fibrosis and massive cancerous involvement. The patient died of recurrent cancer 3 years after the operation. In the minute sessile lesion, bleeding spots on the surface may suggest invasive cancer with massive cancer involvement within the submucosal layer.     

Urinary trypsin inhibitor and biliary atresia--providing protection for the liver?

Urinary Tyrosine Inhibitor (UTI) is produced in the liver and excreted in urine hepatic inflammation, infection or malignancy. We assess the possible implications of UTI in biliary atresia (BA). Liver function was used to divide 34 postoperative BA patients into 2 groups: Group 1 (n=25), anicteric (total bilirubin [T-Bil] <2.0 mg/dl); and Group 2 (n = 9), icteric (total bilirubin >2.0 mg/dl) with abnormal liver function test results, and repeated episodes of cholangitis. 26 age-matched subjects with no history of liver disease acted as controls