Cardiac angiosarcoma is a rare disease which occurs most often in young males and has a remarkably unfavorable prognosis. We experienced one male case aged 46 who had an initial symptom of cardiac tamponade due to rupture of the right ventricle. Hemostasis was made under extracorporeal circulation, and the patient was discharged temporarily. However, a large volume of hemoptysis occurred from right B₆ about 1 month after discharge, because of which resection of the right lower lobe was performed. Tumorous cells identical to those in the perforated cardiac region were detected in the resected tissue, and it was diagnosed histopathologically that the cardiac rupture was caused by angiosarcoma, resulting in pulmonary metastasis. Multiple pulmonary metastases were observed in bilateral lung following fields by CT, but administration of CDDP in iv×2 and in 150mg/day cyclophosphamide, the pulmonary metastases disappeared completely on CT on the 45th day. However, the metastases recurred soon thereafter without responding to chemotherapy, and the patient died 5 months after diagnosis of this disease because of exacerbated dyspnea.

We tried to evaluate the right ventricular function using a modified Swan-Ganz catheter with a rapid responsive thermistor. Twenty-four dogs comprised this series. Twelve were the model of left heart failure (Group A), and the other twelve were the model of right heart failure (Group B) produced by multiple ligation of coronary arteries. Dogs were studied for some of the circulatory indices before and after ligation with left atrial pressure at 10, 15 and 20mmHg in group A, and right atrial pressure at 10, 15 and 20mmHg in group B by volume loading. In group A, when the left atrial pressure was kept constant, right ventricular ejection fraction (RVEF) and right ventricular stroke work index (RVSWI) were decreased significantly after the ligation of coronary arteries. But there was no significant change in the peak right ventricular pressure-right ventricular endsystolic volume index ratio (peak RVP/RVESVI) associated with ligation. In group B, significant changes were observed in RVEF, RVSWI and peak RVP/RVESVI. Thus, it was found that right ventricular contractility in selective left heart failure was not reduced. E_max was considered to be a valuable index of ventricular contractility not affected by preload and afterload of ventricle, but this index is not easily measured clinically. The index peak RVP/RVESVI which is nearly equivalent to E_max, has an advantage in that it can be determined by the thermodilution method widely used in general. We conclude that this index is very useful to us for post-operative care in cardiac surgery.

This paper describes the results of clinical and epidemiological studies of pathogen-carrying madani tick bites and the vector-borne diseases. The studies were conducted by a group of researchers specially organized by the Japanese Association of Rural Medicine.Questionnaires were sent out to JARM-affiliated 108 medical institutions to collect information about cases of ixodiasis, Lyme disease and Japanese spotted fever. It was found that during 2002, there were 151 cases of Ixodes tick bites (67 males and 84 females) and 17 cases of Lyme disease (13 males and 4 females). The incidence of Japanese spotted fever was zero.The survey also found that before that year, 24 out of the 108 medical institutions had treated tick bite cases and 13 handn’t. No reply came from the rest. As to Lyme disease, six hospitals had experienced in treating this vector-borne disease, 31 hadn’t and the rest did not reply. Japanese spotted fever was confirmed by one hospital. Thirty-three hospitals said they had not encountered this disease. The remaining 74 facilities did not respond. It was regrettable that more than a half of the 108 institutions did not respond to the survey. Considering that new types of infectious diseases caused by new forms of pathogens are raging nowadays, we, professionals affiliated with the Japanese Association of Rural Medicine, must keep careful watch on these diseases.
Japanese language ; Ticks ; Genus: Ixodes ; Clinical ; Lyme Disease

This is the second report of the findings of the clinical and epidemiological studies on pathogen-carrying madani tick bites (ixodiasis) and the vector-borne diseases conducted by a study group of researchers specially organized by the Japanese Association of Rural Medicine. The report covers the period from January 1 through December 31, 2004.The same questionnaires that had been prepared in the previous survey were sentto 80 JARM-affiliated medical facilities and 11 non-member medical institutions to collect information about tick bites and resultant infections.It was found that during 2004 there were 134 cases (67 for men and 67 for women) of skin lesions caused by ixodid tick bites, 14 cases of Lyme disease (7 for men and the same for women), and none for Japanese spotted fever. These ixodiasis cases did not show any speciffic difference from those reported previously. All the Lyme disease patients developed erythema migrans which characterize stage 1 infection.As there is still plenty of catching up to do in terms of coping with the tick bite problems in Japan, we referred to some literature on the control of ixodid ticks, serologic testing techniques for Lyme disease, administration of prophylactic antibiotics and therapeutic methods.
Ticks ; Clinical ; Lyme Disease ; seconds ; Japanese language

Methods: Sixty patients with PCSA who underwent surgical treatment of the cervical spine were enrolled. The radiological findings on plain radiographs, computed tomography (CT), and magnetic resonance imaging (MRI) were evaluated. The cervical lordotic angles, C2–C7 sagittal vertical axis (SVA), and T1 slope were assessed on a lateral radiograph in the neutral position. CT was used to assess the width of the intervertebral foramen and the anterior protrusion of the superior articular process on the axial view. MRI was used to determine the number of levels of compression (NLC) and the presence of a high-intensity area in the spinal cord in the T2- weighted midsagittal view. The preoperative and postoperative strengths of the most atrophic muscles were evaluated using manual muscle testing. Improvements in strength were classified as excellent (five grades recovered), good (more than one grade recovered), fair (no improvement), or poor (worsened). Results: The prevalence of C5 palsy was 17% (10/60). Patients with poor outcomes had higher NLC and Δ C2–C7 SVA than patients with excellent, good, and fair outcomes (p =0.015; odds ratio [OR], 5.758; 95% confidence interval [CI], 1.397−23.726 for a change of 10% and p =0.048; OR, 1.068; 95% CI, 0.992−1.141 for a change of 10%, respectively). Conclusions ΔC2–C7 SVA and NLC may be used as prognostic factors for achieving a poor outcome following surgery in patients with PCSA. More focus is needed on preventing the increase in ΔC2–C7 SVA.

Objective: Bevacizumab maintenance therapy following platinum-based combination chemotherapy for metastatic, recurrent, or persistent cervical cancer is not recommended as standard therapy. This pilot study aimed to evaluate the efficacy and safety of bevacizumab maintenance therapy and the contribution of the platinum-free interval to the efficacy of subsequent chemotherapy for advanced cervical cancer. Methods: We retrospectively identified 115 patients with metastatic, recurrent, or persistent cervical cancer treated with platinum-paclitaxel chemotherapy plus bevacizumab at 7 institutions between 2015 and 2020. The primary endpoints were overall survival (OS) and progression-free survival (PFS) in patients who received bevacizumab maintenance therapy and those who did not. We also analyzed the adverse events associated with bevacizumab and survival time from the start of subsequent chemotherapy in both groups. Results: Following platinum-paclitaxel plus bevacizumab chemotherapy, 34 patients received bevacizumab maintenance therapy and 81 patients did not. Of the 115 patients, 56 received chemotherapy for subsequent relapse. Although bevacizumab maintenance therapy prolonged PFS (median of 16.0 months vs. 9.0 months, p=0.041), significant differences were not observed in OS (p=0.374). Furthermore, bevacizumab maintenance therapy did not prolong OS and PFS after the start of subsequent chemotherapy (p=0.663 and p=0.136, respectively). Bevacizumab maintenance therapy significantly increased hypertension (p=0.035) and proteinuria (p=0.005) but did not cause complications leading to death. Conclusion Bevacizumab single-maintenance therapy for advanced cervical cancer can be considered in selected cases, such as those with acceptable bevacizumab-related side effects. The outcomes of our study will likely contribute to decision-making regarding practical treatment strategies.

AIMTo evaluate the occurrence and prevalence of microdeletions in the gamma chromosome of patients with azoospermia.

METHODSDNA from 29 men with idiopathic azoospermia was screened by polymerase chain reaction (PCR) analysis with a set of gamma chromosome specific sequence-tagged sites (STSs) to determine microdeletions in the gamma chromosome.

RESULTSDeletions in the DAZ (deleted in azoospermia) loci sgamma254 and sgamma255 were found in three patients with idiopathic azoospermia, resulting in an estimated frequency of deletions of 10.7% in idiopathic azoospermia men.

CONCLUSIONWe conclude that PCR analysis is useful for the diagnosis of microdeletions in the Y chromosome, which is important when deciding the suitability of a patient for assisted reproductive technology such as testicular sperm extracion-intracytoplasmic sperm injection (TESE-ICSI).

Adult ; Base Sequence ; Chromosomes, Human, Y ; DNA Primers ; Euchromatin ; genetics ; Follicle Stimulating Hormone ; blood ; Heterochromatin ; genetics ; Humans ; Luteinizing Hormone ; blood ; Male ; Oligospermia ; blood ; etiology ; genetics ; Polymerase Chain Reaction ; Prolactin ; blood ; Sequence Deletion ; genetics ; Sequence Tagged Sites ; Testosterone ; blood