ISCHEMIC ENTEROCOLITIS WITHOUT ARTERIO–OCCLUSIVE LESION

Four cases of Ischemic enterocolitis without arterio–occlusive lesion were described. Three cases were associated with sigmoid colon carcinomas. Ischemic lesions developed anal to the carcinomas in two cases, and oral to sigmoidostomy to relieve intestinal obstruction by carcinoma in one case. One other case was associated with inguinal hernia. Grossly, ischemic lesions involved relatively short intestinal segments, and the ischemic colonic lesions were not related to teniae coli. Extensive veno–occlusive lesions were discovered in a case of ischemic stricture of the ileum, which had been incarcerated in the right inguinal hernia. Reversible mechanical occlusion of the intestinal vessels caused by transient or recurrent intestinal strangulation is the most probable cause of these ischemic lesions., ACTA PATHOL. JPN. 33: 249–256, 1983.     

Purification of human blood basophils using negative selection by flow cytometry

Basophils were purified from peripheral blood of normal donors using Percoll discontinuous gradients and negative selection by flow cytometry. The mean purity of basophils obtained was 84.7 +/- 4.1 (s.d.)% (range 77.3-90.0%, n = 13). The overall yield of these procedures was 16.0 +/- 2.6% (range 11.0-19.9%, n = 13), and cell viability of purified basophils exceeded 90%. Properties of highly purified basophils obtained by flow cytometry did not differ from those of partially enriched basophil preparations from Percoll discontinuous gradients in respect of: (i) intracellular histamine content; (ii) percentage of spontaneous histamine release in buffer; and (iii) percentage of histamine release triggered by ionophore A 23187 or anti-IgE. Moreover, purified basophils responded chemotactically to complement C5a in a dose-dependent manner. These findings suggest that our procedure for purification of human basophils does not affect the functions of basophils and may be useful for in vitro studies on the role of basophils in hypersensitivity reactions such as bronchial asthma.     

Cavernous hemangioma of the urinary bladder in an 8-year-old child

An 8‐year‐old boy was admitted to Ehime University Hospital, Ehime, Japan, for the further investigation of a 5‐month episode of gross hematuria accompanied by lower abdominal pain. Magnetic resonance imaging revealed a solid tumor measuring 3 cm in diameter of the bladder wall. Cystoscopy demonstrated a red, wide‐based, nodular tumor situated on the dome of the bladder. Histological examination of tissue taken at hot biopsy showed fibrolipoma. In consideration of potential malignancy, a partial cystectomy was carried out after informed consent was given. Histological examination of the resected specimen showed it to be cavernous hemangioma.     

Posttraumatic stress disorder as a function of the traumatic event, posttrauma stress and pretrauma vulnerability

We conducted two-stage studies on disaster victims and firefighters in the aftermath of the 1995 Hanshin–Awaji Earthquake. Posttrauma stress, high neuroticism and peritraumatic dissociation were suggested as strong contributing factors to posttraumatic stress disorder symptoms in the later stage after the event.     

Beta interferon therapy for chronic hepatitis C in patients with haemophilia and other haemorrhagic disorders

Summary. Beta interferon therapy was given to seven chronic hepatitis C patients with haemophilia or other haemorrhagic disorders who had received clotting factor replacement therapy. Serum alanine aminotransferase (ALT) levels ranged from 82 to 275 UL^-1 and hepatitis C virus (HCV)-RNA ranged from 10⁶ to 10⁹ copies mL^-1. HCV-genotypes were I+II in one patient, II in one, II+III in four and IV in one. Patients received 6 mega units (MU) daily of natural type beta interferon by intravenous infusion for 6 weeks. In three of seven patients, the protocol was modified to intermittent administration because neutrocytopenia (under 500 × 10⁶ L^-1) developed in two patients and thrombocytopenia (under 50 × 10⁹ L^-1) was observed in one during treatment. No modification was necessary with regard to daily and total dose. All patients received administration without any haemorrhagic complications. Six of seven patients showed improvement in serum ALT levels, and one of the patients showed normalization of ALT levels for 6 months after treatment. HCV-RNA disappeared in four patients by the end of treatment, although no one remained negative 6 months after treatment. The results of our study were similar to those reported in previous papers which described the use of alpha interferon in haemophiliacs. The reason none of the patients showed sustained loss of HCV-RNA after therapy might be associated with high HCV-RNA levels, characteristics of the HCV-genotype and prolonged duration of the disease.     

Usefulness of contrast-enhanced ultrasound for the diagnosis of recurrent renal cell carcinoma in contralateral kidney

We studied contrast-enhanced ultrasound (CEU) for recurrence of renal cell carcinoma (RCC) at the contralateral kidney during postoperative follow up of localized renal cell carcinoma. CEU successfully detected all recurring cases, despite the fact that 5/6 cases were observed using conventional ultrasound; the remaining one case was not detected using conventional ultrasound. CEU using Levovisto successfully revealed renal tumors as RCC. Lesions were diagnosed as cystic renal tumors by Bosniac classification, and pathological findings demonstrated RCC, in accordance with the prior tumor.     

Growth of patients with congenital hypothyroidism detected by neonatal screening in Japan

BACKGROUND: The growth of patients with congenital hypothyroidism detected by neonatal screening in Japan was investigated. The data investigated were obtained from Medical Aid Program for Chronic Pediatric Diseases of Specified Categories registered in 2002. METHOD: The present study included 2341 patients (1030 male, 1311 female) registered as having congenital hypothyroidism. To investigate the growth of these patients, their heights plotted on cross-sectional growth charts for boys and girls, their bodyweights expressed as percentage of bodyweight for height and the frequency distribution of percentage of bodyweight for height were assessed. RESULTS: Cross-sectional growth charts of both male and female patients showed that the heights of the majority of the patients with congenital hypothyroidism were within +/-2SD. Approximately half of the patients with heights below -2SD, had some complications. The mean percentages of ideal bodyweights for height were 103.0 +/- 12.9% for both sexes (+/-SD, n = 2033), 103.3 +/- 12.7% for boys, and 102.7 +/- 12.9% for girls. The frequency distribution of percentage of bodyweight showed no tendency of shifting to either ends in comparison with normal distribution curve. CONCLUSION: Patients with congenital hypothyroidism detected by neonatal screening had normal growth in general, suggesting that the neonatal screening system is being performed efficiently from detection to treatment of the disease in Japan. However, it remains unclear whether some uncomplicated patients with a height below -2 SD are sufficiently treated or not. Close observation of these patients may be needed.     

Oral appliance treatment for obstructive sleep apnoea patients with severe dental condition

Summary This clinical report introduces and evaluates the use of a mandibular advancement oral appliance (OA) attached to a denture base for the treatment of obstructive sleep apnoea syndrome (OSAS) in a patient presenting severe dental problems and multiple missing teeth. It concerned a 58‐year‐old man with moderate OSAS (apnoea index (AI): 15·9 h^?1; apnoea hypopnea index (AHI): 21·7 h^?1), presenting ten remaining teeth (maxilla: 5, mandible: 5) and important dental and periodontal problems. A treatment OA comprising both maxillary and mandibular parts was fabricated with an acrylic resin base, simulating the structure of a conventional removable partial denture (RPD). The polysomnography examination performed after the use of the OA showed the treatment induced a significant decrease in OSAS symptoms (AI: 0·7 h^?1, AHI: 8·2 h^?1). All the necessary dental and periodontal treatments were performed to assure the reestablishment of oral health. The treatment OA was modified after each treatment to adapt it to each new oral condition. After 18 months, once the oral health was reestablished with seven remaining teeth (maxilla: 5, mandible: 2), final RPDs and final OA were fabricated. Polysomnography with final OA showed a similar positive result with respect to OSAS symptoms. No side effects related to the OA treatment were detected during the 3‐year follow‐up. To keep a sound oral condition, periodical dental care was performed by specialists in both periodontal and prosthodontic clinics. This clinical report shows the feasibility of treating OSAS patients with OA even in the presence of severe oral conditions and multiple missing teeth.