Japanese Versus Non-Japanese Patients with Transient Ischemic Attack or Minor Stroke: Subanalysis of TIA registry.org

BackgroundTIAregistry.org is an international cohort of patients with transient ischemic attack (TIA) or minor stroke within 7 days before enrollment in the registry. Main analyses of 1-year follow-up data have been reported.⁵ We conducted subanalysis on the baseline and 1-year follow-up data of Japanese patients.MethodsThe patients were classified into 2 groups based on Japanese ethnicity, Japanese (345) and non-Japanese (3238), and their baseline data and 1-year event rates were compared. We also determined risk factors and predictors of 1-year stroke.ResultsCurrent smoking, regular alcohol drinking, intracranial arterial stenosis, and small vessel occlusion; and hypertension, dyslipidemia, coronary artery disease, and extracranial arterial stenosis were more and less common among Japanese patients, respectively. Stroke risk was higher and TIA risk was lower at 1-year follow-up among Japanese patients. The baseline risk factors for recurrent stroke were diabetes, alcohol drinking, and large artery atherosclerosis. Independent predictors of 1-year stroke risk were prior congestive heart failure and alcohol consumption.ConclusionsThe two populations of patients featured differences in risk factors, stroke subtypes, and outcome events. Predictors of recurrent stroke among Japanese patients included congestive heart failure and regular alcohol drinking. Strategies to attenuate residual risk of stroke aside from adherence to current guidelines should take our Japanese-patient specific findings into account.     

A case of recurrent biliary cystadenocarcinoma successfully treated with 5FU/CDDP systemic chemotherapy]

We report a case of biliary cystadenocarcinoma which recurred 41 months postoperatively. A 60-year-old woman was admitted for further examination of multiple metastatic tumors and a large amount of ascites. Systemic administration of 5FU and CDDP caused her CEA level to decrease gradually and abdominal computed tomography revealed considerable reduction of the metastatic tumors and ascites. Since her general condition had improved, chemotherapy was continued in the outpatient clinic.     

A nationwide survey on transient hyperammonemia in newborn infants in Japan: prognosis of life and neurological outcome.

A nationwide survey of transient hyperammonemia in newborns was carried out in Japan. A total of 18 patients, consisting of 12 male and 6 female infants, were reported from 11 facilities. These neonates exhibited hyperammonemia with plasma ammonia levels in the range from 124 to 6256 micrograms/dl. Four newborn infants of the 18 died in the neonatal period, and an additional one died in the early infancy. Among the 13 infants who were alive at the time of this survey, 6 had neurological sequelae, including mental retardation, spastic quadriplegia and epilepsy. The multivariate analysis revealed that the Apgar score at 1 minute, peak plasma ammonia concentration, birth weight and sex were significant factors affecting the prognosis of life.     

Follow-up cytology in the management of urotheliomas

Ninety-one patients with operation history for urotheliomas were followed-up by urinary cytology for 17.5 months on the average. Cytologically, fresh urine was examined every month and vesical irrigation fluid every three months. Cystoscopy was also performed every three months, IVP every six months, and biopsy was performed when carcinoma or dysplasia was suspected. As a result, cases were classified into four groups. Group 1: All cytological examination were negative. Group 2: Cytology was positive for two or three months after TUR-Bt during which period vesical instillation therapy of anti-cancer drugs was performed, but was negative after this period. Group 3: Positive and negative cytology were diagnosed irregularly. Group 4: All cytological examinations were positive. The numbers of cases classified into these groups were 27 (29.7%), 7 (7.7%), 43 (47.3%) and 14 (15.4%), respectively. Tumor recurrence was seen in 1/27 (3.7%), 0/7, 12/43 (27.9%) and 4/14 (28.6%) cases, respectively. Metastasis was seen in only five cases of the group 4. Tumor recurrence and positive urinary cytology at the same time were seen in nine cases (20.9%) of group 3, and eight cases (57.1%) of group 4. Thirty four cases (79.1%) with discrepancy of cytological and endoscopic findings in group 3, in which cases 20 cases had only positive irrigation cytology and 11 cases had positive fresh urine and irrigation specimens, were more suspicious of temporary existence of in situ carcinomas or dysplastic urothelium. Of six cases with the discrepancy in group 4, three cases were in situ carcinoma diagnosed by random biopsies, and four cases had positive cytologies after TUR-Bt continuously.(ABSTRACT TRUNCATED AT 250 WORDS)     

Alveolar bone graft for patients with cleft lip/palate using bone particles and titanium mesh: A quantitative study.

PURPOSE: This study evaluated the bone volume, height, and width that can be obtained in alveolar ridge augmentation using titanium mesh and autogenous bone particles in patients with cleft lip/palate. PATIENTS AND METHODS: Subjects were 15 patients with cleft lip/palate requiring tertiary bone graft for implant therapy. Computed tomography (CT) scans were taken before removing the mesh, from 1 to 21 months after bone grafting. Forty-three reconstructed images corresponding to the positions for implant placement were selected for this study. The percent defect filled with bone (%BONE), defined as the percentage of newly formed bone in the space created by the mesh, was measured for image analyses. In linear analyses, 4 parameters were used: increased bone height (IBH), percent increased bone height (%IBH), increased bone width (IBW), and percent increased bone width (%IBW). Factors influencing the quantitative data and the clinical courses of placed implants were also explored. RESULTS: The average %BONE was 91.1%. IBH averaged 4.4 mm, whereas %IBH averaged 88.5%. IBW averaged 4.6 mm, whereas %IBW averaged 86.4%. Little correlation was present between the quantitative data and patient age, or time interval. A significant correlation was identified between the data for span of the grafted area and %BONE (correlation coefficient value = -0.36). However, the diminishing rate was very low. No implants were lost postoperatively. CONCLUSIONS: Alveolar ridge augmentation with titanium mesh and autogenous bone particles from the anterior iliac crest has very high predictability as a preimplant procedure in patients with cleft lip/palate.     

门静脉注射白细胞介素-12治疗肝转移肿瘤的实验研究

目的　探讨通过门静脉系统局部应用白细胞介素 12 (IL 12 )对于肝转移肿瘤的治疗作用。方法　通过门静脉注射 2× 10 5个MCA 2 0 5肿瘤细胞建立小鼠肝转移肿瘤模型 ,同时脾脏被移植到皮下 ,作为反复多次向门静脉系统注射的途径。第 3～ 7天 ,0 1μgIL 12通过腹腔或脾脏注射 ,同时对照组中通过脾脏注射等体积的平衡盐水。第 2 1天检查肝转移肿瘤的情况。结果　在肝转移模型中 ,IL 12腹腔注射组和IL 12脾脏注射组的肝脏重量 (1 33± 0 0 8)g和 (1 2 9± 0 0 7)g明显小于对照组 (1 92± 0 17)g ,P <0 0 5 ,IL 12腹腔注射组和IL 12脾脏注射组的肝脏转移结节数目 (1 5 3± 0 5 8,0 6 0± 0 89)明显少于对照组 (18 2 5± 5 71,P <0 0 5 )。在IL 12脾脏注射组中 (n =6 ) ,3只小鼠的肝脏肿瘤完全消失。结论　通过门静脉系统局部应用IL 12是治疗肝转移肿瘤的有效方法。