Event-related potential correlates of functional hearing loss: Reduced P3 amplitude with preserved Nl and N2 components in a unilateral case

Abstract A female patient exhibiting functional hearing loss in her left ear demonstrated reduced amplitude of P3 component in event-related potentials (ERP) to left monaural stimulation, with preserved N1 and N2 components to stimulation of either ear. This result suggested that stimuli in the affected ear were conducted successfully up to the auditory cortex but that further processing in higher brain regions was 'repressed'. Event-related potential examination for such hysterical disorders could be useful in clarifying their brain mechanism and offer a useful diagnostic clue to its nature.     

Cholestatic hepatocellular carcinoma diagnosed by deposits of Lipiodol and treated by combination of endoscopic retrograde biliary drainage and transcatheter arterial embolization

Cholestatic hepatocellular carcinoma, which grows into the bile duct and causes obstructive jaundice, is rare and difficult to diagnose. A case is presented in which cholestatic hepatocellular carcinoma was detected by deposit of Lipiodol. This is also the first case that was successfully treated by endoscopic retrograde biliary drainage and transcatheter arterial embolization.     

VDD Pacing with a Previously Implanted Single Lead System

Three patients who had undergone implantation of a rate modulated, afrial sensitive RS4 pacemaker, with a single orthogonal lead underwent replacement of a depleted unit with a DDD pulse generator, reusing the original lead with an adapter that allowed conversion of the bipolar atrial electrode into unipolar configuration. The mean atrial electrogram amplitude was 1,8 mV and no significant atrial sensing defects were found during Holler monitoring. As the RS4 pulse generator is no longer available, continued VDD pacing is possible by replacing it with a DDD pulse generator using the previously implanted single lead system.     

Alpha-delta sleep in a case with non-24 h sleep-wake syndrome: Quantitative electroencephalogram analysis of alpha and delta band waves

Abstract  Four all-night polysomnograms of a 39-year-old male patient with non-24 h sleep-wake syndrome were recorded. We analysed electroencephalograms (EEG) with the power spectrum method and the wave pattern recognition analysis of Fujimori. The EEC of the rest waking condition showed normal patterns. High-voltage diffuse alpha band waves were observed in sleep stages 2, 3 and 4. The integrated area of the alpha band waves in the analysis epochs showed a strong positive correlation to the delta hand components in the power spectrum of the same epoch during sleep (correlation coefficients r = 0.762–0.815). Alpha hand waves during sleep were clearly different from the alpha waves in the rest waking condition, with respect to slower peak frequency and the frontal dominant voltage distribution.     

Morphological Study of Pancreas Divisum in Niigata Using ERCP

Abstract: The morphological characteristics and incidence of pancreas divisum (PD) in Niigata were investigated by studying 16,646 cases diagnosed by ERCP. These cases had been patients in 16 hospitals located in Niigata prefecture. PD was found in 114 (63 cases confirmed, 51 cases unconfirmed) of these 16,646 cases (0.68%). An unconfirmed case was defined as being a patient in whom only the short ventral pancreatic duct was visible through the main papilla, and the confirmed cases were classified into the 3 types according to the ductal systems of the dorsal and ventral pancreas. The classification of these 3 types was as follows. Type 1: Nonfusion between the ventral (VPD) and dorsal pancreatic ducts (DPD), which was visualized through the main papilla (MP) and the accessory papilla (AP), separately. Type 2: Only DPD was visualized through the AP. In spite of the cannulation of the MP, the VPD was not demonstrated. Type 3: Miscellaneous cases. The frequency of Type 1, Type 2, and Type 3 was 58.7% (37 cases), 28.6% (18 cases), and 12.7% (8 cases), respectively. Type 3 consisted of two subtypes. One (7 cases) was regarded as being when the patient had a very fine communicating branch between VPD and DPD, whether an obvious communicating branch could be detected or not by ERCP. The other subtype (only one case) showed very strange findings in which through the AP a short pancreatic duct distributed to the head of the pancreas and to the uncinate process was visualized and in which through the MP a long pancreatic duct to the tail was demonstrated, separately.     

Efficacy of 308-nm excimer light for Japanese patients with psoriasis

Ultraviolet irradiation therapy, including psoralen and ultraviolet A therapy and narrow-band ultraviolet B (310–312 nm) therapy, is a widely used and highly efficient treatment modality for psoriasis. Therapy with 308-nm excimer light has been reported to be effective for the treatment of psoriasis vulgaris. To evaluate the efficacy of 308-nm excimer light therapy for Japanese psoriasis patients, seven patients (six men and one woman) with plaque-type psoriasis were treated with 308-nm excimer light at 7–14-day intervals. The Psoriasis Severity Index (PSI) was calculated for individual plaques in order to assess the effectiveness of the therapy. A 74.9% mean improvement in the PSI was observed after 10 treatment sessions. These results suggested that targeted irradiation with 308-nm excimer light leads to rapid and selective improvement in plaque-type psoriatic lesions without unnecessary radiation exposure to the surrounding unaffected skin.     

Present Situation of Eus‐Fnab in our Institute and Future Appropriate Direction of This Procedure in Japan

We describe the present view of performing diagnostic endoscopic ultrasonography guided fine needle aspiration biopsy (EUS‐FNAB). In the pancreatic diseases, our application of EUS‐FNAB for pancreatic disease has been as follows: as to the operable cases, EUS‐FNAB should not be performed through any pathway penetrating the duodenum and the stomach. EUS‐FNAB is contraindicated in cystic diseases. As to the cases diagnosed as inoperable with various imaging modalities, EUS‐FNAB should be performed to obtain the pathological evidence. In gastrointestinal disorders, all intramural diseases are appropriate indications for this procedure. Even if the target lesion is in the far oral part of the large intestine, we perform EUS‐FNAB by the special method described in this paper. Lymphadenopathy for appropriate cases is one of the best cases in which to perform EUS‐FNAB. Mediastinal lymph node metastasis influences the treatment plan of lung cancer; the application of this treatment is increasing in our institute.     

A Study of Reflux Esophagitis in an Apparently Healthy Population

Abstract: To study reflux esophagitis in the general population, we reviewed the records of 64,171 apparently healthy Japanese adults, 48, 706 men and 15,465 women, who had undergone automated multiphasic health testing and services (AMHTS), a comprehensive routine medical health check, that includes double-contrast upper gastrointestinal roentgenograms. All subjects suspected of having gastrointestinal disease underwent a flexible fiberscopy as indicated. Reflux esophagitis was thus confirmed in 101 subjects. The prevalence of refla esophugitis was 0.20% among men and 0.04% among women (men vs. women p<0.001) and its frequency increased with age in both men (p<0.001) and women (p<0.05). Endoscopic classification according to the Savary-Miller criteria yielded 48, 27, 23, and patients in Stage I, II, III and IV, respectively. In this series, 49/101 (48.5%) of the esophagitis patients had concurrent upper gastrointestinal abnormalities. The incidence of heavy smoking and excessive drinking of alcohol was significantly higher in the patients with reflux esophagitis (p<0.001 and p<0.005, respectively) as compared with the normal population.     

Anti-oxidant action of metronidazole: a possible mechanism of action in rosacea

To elucidate the mechanism of action of metronidazole in the treatment of rosacea, the effect of metronidazole on the generation of reactive oxygen species was examined both in neutrophil and xanthine-xanthine oxidase systems. Metronidazole had anti-oxidant action which was not exerted by the scavenging of reactive oxygen species, but by having an effect on neutrophil cell functions. Beneficial effects of metronidazole in the treatment of papulopustular rosacea can in part be attributable to this anti-inflammatory effect.