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.     

Advanced prostate cancer with extremely low prostate-specific antigen value at diagnosis: An example of high dose hook effect

A 67-year-old man presented with a lower abdominal mass. Radiographic examination revealed a huge mass filling the entire pelvis. Although prostate-specific antigen (PSA) was 1.4 ng/ml, percutaneous needle biopsy revealed adenocarcinoma compatible with prostate cancer, which stained positive for PSA. Hormone therapy was initiated and 1 month later his PSA was as high as 2713 ng/ml, although the mass had decreased in size. High dose hook effect was suspected and hormone therapy was continued. PSA is presently under control and below 0.1 ng/ml. When prostate cancer with very high PSA is suspected and the PSA value is unexpectedly low hook effect should be considered and PSA should be re-analyzed.     

Epidemiology of poliomyelitis in Karachi,Pakistan: Prospective studies during 1990–93

Between October 1989 and September 1993, 245 cases of poliomyelitis visited the Department of Pediatrics, Civil Hospital Karachi, Pakistan. The majority of them were between 6 months and 2 years of age and the epidemic occurred during the hot season. The dominant serotype was polio type 1. All of the polioviruses isolated from the patients were wild type. Virological studies also disclosed that enteroviruses other than polioviruses were prevalent among healthy children as well as diarrheal and polio patients. Serodiagnosis by poliovirus-specific immunoglobulin M antibody tests using the capture enzyme-linked immunosorbent assay method were in good agreement with the results of virus isolation. The present study demonstrated that Pakistan is a region endemic for wild poliovirus and more aggressive preventive measures are needed to eradicate poliomyelitis from the region.     

A longitudinal study of blood pressure,cholesterol and left ventricular muscle volume in children: The Shimane Heart Study

Three hundred and forty-four healthy schoolchildren living in Izumo City, Shimane Prefecture, Japan, were assessed at 3 year intervals from 6 to 15 years, starting in 1978 (Cohort 1) or 1981 (Cohort 2). Tracking indices (Ti) were calculated as follows: Ti = (2x + y - z)/N/0.89, where x, y and z refer to the total number in the same, adjacent and remote trisections, respectively, and N = x + y + z. If Ti > 1, there is positive tracking. For systolic blood pressure (SBP) measurements (except at 6 years old) and serum cholesterol levels, all Ti were greater than 1.0 regardless of the time when tracking was commenced. Tracking indices were slightly greater in the serum cholesterol levels than in the SBP measurements. Left ventricular muscle volume indices (LVMVI) were calculated by echocardiographic measurements. In girls, the LVMVI was larger only in the above-median SBP group at the age of 12 years (P < 0.01), but the LVMVI of the higher SBP (above median) group was larger than in the lower (below median) group at every age in boys; the difference was statistically significant (P < 0.05) at 12 and 15 years of age. Left ventricular mass enlargement may occur in the prehypertensive stage in humans as well as in rats.     

Necrotizing fasciitis resulting from Escherichia coli in a patient with chronic rheumatoid arthritis

A middle‐aged woman with rheumatoid arthritis was admitted because of cellulitis on the leg. Twenty‐four hours after admission haemorrhagic blisters and bullae appeared on the lower extremity. Despite intensive therapy she died due to multiple organ failure at 50 h after admission. Post‐mortem examination revealed diffuse necrosis of fascia in her leg. Bacteriological study showed Escherichia coli in her blood cultures and fluid from a bulla, indicating that she had necrotizing fasciitis resulting from Escherichia coli. Necrotizing fasciitis is an uncommon but potentially fatal infection; thus, this disease should be considered in the differential diagnosis of any cutaneous manifestations in patients with rheumatoid arthritis.     

Assessment of Underlying Blood Vessels in Gastric Ulcers with Bleeding Episode by Endoscopic Color Doppler Ultrasonography

We used endoscopic color Doppler ultrasonography to detect hemorrhagic gastric ulcer, and to determine whether this modality could show blood vessels present deep to ulcers and whether these vessels influenced clinical course. Subjects were 20 patients with hemorrhagic gastric ulcers which had visible vessels on the ulcer base endoscopically. In 11 of 20 patients (group P) color signals indicating blood flow were observed, in which a weak pulsatile wave was detected in five cases. In two operated cases the signals were confirmed as blood vessels histologically. The diameters of these vessels were over 0.35 mm. It was thought that in cases undetectable on endoscopic color Doppler ultrasonography (group N) the diameter of vessels was too narrow or the velocity of blood too slow. There were no differences in the clinical background of group P and group N. However, ulcer bleeding was more severe in group P cases (P<0.05). Many patients in whom blood flow was detected experienced repeated ulcer bleeding as well as ulcer recurrences. Patients with hemorrhagic ulcers and in whom ultrasonic imaging demonstrates blood flow should be managed with great care. (Dig Endosc 1999; 11: 231–235)     

Results for 79 patients with neuroblastoma detected through mass screening at 6 months of age in a single institute

BACKGROUND: In Japan, mass screening for neuroblastoma has been performed at 6 months of age to improve the prognosis of this condition for more than 20 years. In recent years, most neuroblastomas detected by mass screening were considered to have favorable biological features and sometimes tend to regress spontaneously. METHODS: The authors established non-treated observation criteria in 1997 and criteria for observation of residual tumor after first-line chemotherapy in 1999, and have made an effort to reduce the intensity of medical treatment for neuroblastoma. The authors examined outcomes of 79 patients who were found in the Shizuoka neuroblastoma mass screening at 6 months of age and who received medical treatment or underwent observation in Shizuoka Children's Hospital, Shizuoka, Japan, between December 1981 and December 2004. RESULTS: A total of 77 patients survived but the remaining two patients died from complications of medical treatment. None of the patients died due to progression of neuroblastoma. In the cases, non-treated observation was performed in 17. Of those, 12 patients are now under non-treated observation. Of their tumors, two have disappeared, nine have become smaller and another one has not change in size. Observation of residual tumor after first-line chemotherapy was performed in 15 cases, and three disappeared and the other 12 cases became smaller. Medical treatment-related complications were observed in 20 of 67 patients who received medical treatment, and 18 of the 20 patients were seen before establishing non-treated observation criteria. CONCLUSION: Non-treated observation and observation of residual tumor after first-line chemotherapy were useful to reduce medical treatment-related complications.     

The effect of changing the maxillomandibular relationship by a bite plane on the habitual mandibular opening and closing movement

The relationship between the change of afferent information from occlusal contacts and its influence on the jaw muscles was investigated. For this purpose, the following questions were posed and experimental studies designed. If the subject was given habitual occlusal contacts in centric relations with a bite plane, were the habitual mandibular closing and opening movements influenced? Second, was it easier for the subjects to accomplish regular habitual mandibular opening and closing movements, when the bite plane was inserted and removed? From the results it could be concluded that the centric occlusal contacts in centric relation were more physiological for the jaw muscles. In addition, when the new occlusal position was coincident or close to the centric relation, it was easier for the subject to study and acquire the new habitual mandibular opening and closing movement.