2.Pott's Disease and Cold Abscesses
Daisuke Kurai ; Takeshi Saraya ; Manabu Ishida ; Akira Nakajima ; Yukari Ogawa ; Yasutaka Tanaka ; Hajime Takizawa ; Hajime Goto
General Medicine 2012;13(2):110-112
Tuberculous spondylitis, or so-called Pott's disease, seems to be overlooked because of a lack of severe inflammation in the insidious generating process and tends to cause non-specific symptoms, such as back pain, fever, weakness, and weight loss. Diagnostic delay is common and the results can be disastrous. Discriminating between Pott's disease and other diseases, such as malignancy and pyogenic infection, is difficult. However, the inflammatory process in Pott's disease tends to spare the disk space, while that of pyogenic infection typically affects the area. Herein, we present a patient with Pott's disease who showed the characteristic clinical and radiological findings.
4.A Case of Successful Surgical Repair of Thoracic Aortic Aneurysm after Revascularization of Single Functioning Ischemic Kidney
Setsuo KURAOKA ; Shigetaka KASUYA ; Takao IRISAWA ; Satoshi GOTO ; Hajime OOZEKI ; Hiroshi KANAZAWA ; Isao SAKASHITA
Japanese Journal of Cardiovascular Surgery 1992;21(6):597-599
A case is described of the staged surgical repair of thoracic aortic aneurysm after revascularization of single functioning ischemic kidney of a 68 year old man. A hitological evaluation of renal function was obtained before renal revascularization, which encouraging us to perform the repair of thoracic aortic aneurysm with less risk of post-surgical acute renal failure. In case of single ischemic kidney, renal revascularization should be preceded to other major surgeries in order to prevent renal shut down.
5.Bronchial Schwannoma Masquerading as Cause of Hemoptysis in a Patient with Pulmonary Embolism
Tomoko Nagatomo ; Takeshi Saraya ; Masuo Nakamura ; Yasutaka Tanaka ; Akira Nakajima ; Atsuko Yamada ; Yukari Ogawa ; Naoki Tsujimoto ; Erei Sohara ; Toshiya Inui ; Mitsuru Sada ; Manabu Ishida ; Miku Oda ; Ichiro Hirukawa ; Masachika Fujiwara ; Teruaki Oka ; Hidefumi Takei ; Tomoyuki Goya ; Hajime Takizawa ; Hajime Goto
General Medicine 2013;14(1):67-71
A 78-year-old woman who had a history of left deep venous thrombosis was referred to our hospital with a sudden hemoptysis. Thoracic computed tomography showed a solitary pulmonary nodule in the right lower lobe. Based on her medical history of deep venous thrombosis, she was tentatively diagnosed as having pulmonary embolism and successfully treated by inserting an inferior vena cava filter and anticoagulant therapy with warfarin [Please confirm whether previous sentence is correct]. However, the lung nodule on thoracic computed tomography was still depicted four months later. With suspicion of a malignant tumor, including possible lung cancer, a right segmentectomy was performed. Pathological assessment of the resected specimen showed the tumor was derived from the right bronchial wall, but was not ruptured into the intratracheal lumen, as well as coexistence with intraalveolar hemorrhage near the tumor. The lung nodule was diagnosed as bronchial schwannoma. Thus, the origin of the hemoptysis was found to be pulmonary embolism due to deep vein thrombosis, and not by bronchial schwannoma, which was also present in the lung.
7.Feasibility of Newly Developed Endoscopic Ultrasound with Zone Sonography Technology for Diagnosis of Pancreatic Diseases.
Yoshiki HIROOKA ; Akihiro ITOH ; Hiroki KAWASHIMA ; Eizaburo OHNO ; Yuya ITOH ; Yosuke NAKAMURA ; Takeshi HIRAMATSU ; Hiroyuki SUGIMOTO ; Hajime SUMI ; Daijiro HAYASHI ; Naoki OHMIYA ; Ryoji MIYAHARA ; Masanao NAKAMURA ; Kohei FUNASAKA ; Masatoshi ISHIGAMI ; Yoshiaki KATANO ; Hidemi GOTO
Gut and Liver 2013;7(4):486-491
BACKGROUND/AIMS: To confirm the feasibility of using newly developed endoscopic ultrasound (EUS) with Zone sonography(TM) technology (ZST; Fujifilm Corp.). METHODS: Seventy-five patients with pancreatic disorders were enrolled: 45 with intraductal papillary mucinous neoplasm; 15 with ductal carcinoma; five with neuroendocrine tumors; three with serous cystic neoplasms; and seven with simple cysts. The endoscopes used were EG-530UR2 and EG-530UT2 (Fujifilm Corp.). Two items were evaluated: visualization depth among four frequencies and image quality after automatic adjustment of sound speed (AASS), assessed using a 5-scale Likert scale by two endosonographers blinded to disease status. Because sound speed could be manually controlled, besides AASS, image quality at sound speeds of 1,440 and 1,600 m/sec were also assessed. RESULTS: In all cases, sufficient images were obtained in the range of 3 cm from the EUS probe. Judgments of image quality before AASS were 3.49+/-0.50, 3.65+/-0.48, respectively. After AASS, A and B scored 4.36+/-0.48 and 4.40+/-0.49 (p<0.0001). There were significant differences in the data before and after AASS and plus 60 m/sec, but no significant difference between the datasets were seen after AASS and at sound speeds manually set for minus 100 m/sec. CONCLUSIONS: EUS with ZST was shown to be feasible in this preliminary experiment. Further evaluation of this novel technology is necessary and awaited.
Endoscopes
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Endosonography
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Humans
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Judgment
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Mucins
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Pancreatic Diseases