Tumor lysis syndrome (TLS) is an oncological emergency characterized by various metabolic abnormalities, such as hyperuricemia, hyperphosphatemia, hyperkalemia and hypocalcemia. Although TLS is rare in solid tumors, it has been reported in various cancers and sarcomas. It can be caused by chemotherapy, radiotherapy, surgical procedures. TLS in solid tumors may be lethal when it once develops. Hence, prophylaxis is considered important in medium risk diseases. We experienced the case that serum lactate dehydrogenase (LDH) level had elevated drastically a month prior to the onset of TLS in hypopharyngeal cancer. It is suggested that monitoring of LDH may be helpful for predicting the onset of TLS.

A 37-year-old man who had received graft replacement of right iliac artery 20 years ago was admitted to our hospital because of massive intestinal hemorrhage. CT scan and angiogram showed a pseudoaneurysm originating from a graft anastomosis and the case was diagnosed as aorto-enteric fistula. Emergency operation was performed. Following aneurysmectomy and direct closure of split anastomosed portions, colostomy was performed in descending colon. Femorofemoral artery bypass was made as an extra-anatomical bypass. Fortunately, he has been successfully treated and is doing well now. The most important point for the rescue of cases of aneurysm-enteric fistula is to consider such cases of intestinal hemorrhage after the arterial graft replacement in the abdomen.

The purpose of this study was to prove the hypothesis that the effect of strength training is memorized and reinforced by retraining. Untrained university-age men participated in this training program. The retraining leg was subjected to 5 weeks of isometric training, 17 weeks of detraining and 5 weeks of retraining in knee extension. The contralateral training leg was subjected to 5 weeks of isometric training during the same period as the retraining phase of the retraining leg. Maximal isometric torque of knee extension increased after the 5-week training and remained at the trained level during the 17week detraining period. Torque gain by retraining of the retraining leg was 2.6 times greater than that of the contralateral training leg. These changes in isometric torque corres-ponded with changes in iEMG of the vastus lateralis. The cross-sectional area of the quadriceps femoris muscle did not change with training. Results support the hypothesis that the effect of strength training is memorized and reinforced by retraining. In addition, results show that these adaptations would be explained by recruitment and rate coding of motor units.

Ulcerative colitis (UC) is 1 of the 2 major phenotypes of chronic inflammatory bowel disease (IBD), which afflicts millions of individuals throughout the world with debilitating symptoms that impair function and quality of life. Further, IBD often affects women during childbearing age. Indeed, UC activity frequently increases during pregnancy, and the medications used to induce remission may adversely affect the health of the mother and the unborn child. We report successful induction of a remission in a UC case who experienced a flare-up in the first trimester of pregnancy. Upon relapse, she was treated with steroids and adsorptive granulomonocytapheresis (GMA) with the Adacolumn plus tacrolimus. This combination therapy induced a stable remission that was maintained during her entire pregnancy. She gave birth to a healthy child at 36 weeks of pregnancy with no maternal or fetal complications. Our experience indicates that GMA, as a non-drug therapeutic intervention with a favorable safety profile, plus tacrolimus might be a relevant treatment option for patients with active IBD during pregnancy. A future study of a large cohort of pregnant patients should strengthen our findings.
Child ; Cohort Studies ; Colitis, Ulcerative* ; Female ; Humans ; Inflammatory Bowel Diseases ; Mothers ; Parturition ; Phenotype ; Pregnancy Trimester, First ; Pregnancy* ; Quality of Life ; Recurrence ; Steroids ; Tacrolimus* ; Ulcer*

Background: Poor lifestyle habits may worsen nonalcoholic fatty liver disease (NAFLD), with progression to nonalcoholic steatohepatitis (NASH) and cirrhosis. This study investigated the association between glycemic control status and hepatic histological findings to elucidate the effect of glycemic control on NAFLD. Methods: This observational study included 331 patients diagnosed with NAFLD by liver biopsy. Effects of the glycemic control status on histological findings of NAFLD were evaluated by comparing the following four glycemic status groups defined by the glycosylated hemoglobin (HbA1c) level at the time of NAFLD diagnosis: ≤5.4%, 5.5%–6.4%, 6.5%–7.4%, and ≥7.5%. Results: Compared with the lowest HbA1c group (≤5.4%), the higher HbA1c groups (5.5%–6.4%, 6.5%–7.4%, and ≥7.5%) were associated with advanced liver fibrosis and high NAFLD activity score (NAS). On multivariate analysis, an HbA1c level of 6.5%– 7.4% group was significantly associated with advanced fibrosis compared with the lowest HbA1c group after adjusting for age, sex, hemoglobin, alanine aminotransferase, and creatinine levels. When further controlling for body mass index and uric acid, total cholesterol, and triglyceride levels, the higher HbA1c groups were significantly associated with advanced fibrosis compared with the lowest HbA1c group. On the other hand, compared with the lowest HbA1c group, the higher HbA1c groups were also associated with a high NAS in both multivariate analyses. Conclusion Glycemic control is associated with NAFLD exacerbation, with even a mild deterioration in glycemic control, especially a HbA1c level of 6.5%–7.4%, contributing to NAFLD progression.