A dermatitis of unknowns etiology has occurred among the farmers working in paddy fields in some districts of Kagoshima Prefecture, such as Ibusuki, Hiyoshi, Oura, Makizono and Minami-tane.
In order to acertain the cause of the disease, the epidemiological investigations have been made since1975.
The dermatitis occurrs from March to July when rice-planting and weeding are on and is characterized by erythemato- papulo-vesicular eruptions accompanied with severe itching. The chief symptoms are observed on the parts exposed to water, especially on forearms and lower legs.
The research for snail intermediate hosts was carried out in the paddy fields where the dermatitis originated.
As a result, two species of apharyngeal furcocercous cercariae were obtained from the fresh water snails, Polypylis hemisphaerula and Austropeplea ollula. The cercaria from P. hemisphaerula resembled to that of Gigantobilharzia sturniae in shape and size, and the other one from A. ollula was identified as species belonging to the genus Trichobilharzia and was regarded the same species as described in Saitama Prefecture by the authors.
An experimental infection with the cercaria belonging to the genus Trichobilharzia was performed. A few drops of water containing10cercariae were placed on the forearm. The cercariae invaded into the skin and produced a dermatitis quite similar to that prevailing in the endemic areas.
Therefore, it was concluded that the etiological agent were the cercariae of two different avian schistosomes, namely, G. sturniae and Trichobilharzia sp.

A 63-year-old male patient visited our hospital with a right incidental renal tumor, which was found by ultrasonography for the follow-up study of chronic hepatitis B virus infection and diabetes mellitus. Consecutive computed tomography revealed a right renal tumor and two left adrenal tumors. Further systemic imaging study and hormonal examination suggested one right renal cell carcinoma and left adrenal metastases. We performed right nephrectomy and left adrenalectomy. The pathological diagnoses of all resected tumors were renal cell carcinoma. The patient has been in good health without any recurrence for 12 months since the operation. In patients with renal cell carcinoma, contralateral adrenal metastasis is usually associated with multiple metastases to other organs. There are a few cases of solitary and synchronous contralateral adrenal metastasis in the English literature. To our knowledge, this is the first report of a case of renal cell carcinoma with double synchronous contralateral adrenal metastases.
Adrenal Glands ; Adrenalectomy ; Carcinoma, Renal Cell ; Diabetes Mellitus ; Follow-Up Studies ; Hepatitis B, Chronic ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasms, Multiple Primary ; Nephrectomy ; Recurrence ; Viruses

We investigated annual changes with respect to the period taken from the onset of illness to the prescription of lower extremity orthoses in hemiplegic patients after stroke, retrospectively from 1992 to 2007, in an acute phase hospital. We subdivided the initial period into three parts : the period of time from onset to the beginning of rehabilitation (T1), from the beginning of rehabilitation to the beginning of rehabilitation in the training room (T2), and from the beginning of rehabilitation in the training room to prescription (T3). Analysis was made with respect to the relationship between each of the aforementioned periods and the prescription time. Furthermore, we also analyzed the relationship between the length of stay of patients who had been prescribed orthoses, and the prescription time. The prescription time was found to have gradually shortened over time ; moreover, the period in question shortened in a rapid way in 2001, as compared with previous years (p <0.05). T3 showed the highest correlation coefficient (r =0.99), and the length of stay also exhibited a high correlation coefficient (r =0.97). We assume that the annual changes in prescription time might have been due to various underlying factors, namely, social factors, such as a shortening of the length of stay, caused by the differentiation of roles among hospitals, as well as medical factors such as the development of acute phase rehabilitation, or changes in perception of the ways in which orthoses may be used for stroke patients by rehabilitation staff.

Computed tomography (CT) is widely used in postmortem investigations as an adjunct to the traditional autopsy in forensic medicine. To date, several studies have described postmortem CT findings as being caused by normal postmortem changes. However, on interpretation, postmortem CT findings that are seemingly due to normal postmortem changes initially, may not have been mere postmortem artifacts. In this pictorial essay, we describe the common postmortem CT findings in cases of atraumatic in-hospital death and describe the diagnostic pitfalls of normal postmortem changes that can mimic real pathologic lesions.
Adult ; Aged ; Autopsy/instrumentation/*methods ; Brain/pathology/radiography ; Female ; Forensic Medicine/instrumentation/*methods ; Gastrointestinal Tract/pathology/radiography ; Heart/radiography ; Humans ; Lung/pathology/radiography ; Male ; Middle Aged ; Myocardium/pathology ; Postmortem Changes ; Tomography, X-Ray Computed/*methods

Introduction: We experienced a case of lung cancer in which arthrocentesis and radiation were effective in treating pain caused by malignant joint fluid. Case: An 80-year-old man was referred to our hospital because of right shoulder pain and difficulty in raising his right hand. Whole body computed tomography (CT) showed right lung tumor, multiple liver metastases and multiple bone metastases. There were also bone metastases in the right scapula and joint fluid accumulation in the right shoulder joint. He was irradiated for bone metastases in the right scapula, but the pain remained, although it had not worsened. Therefore, an arthrocentesis of the right shoulder joint was performed and pain was alleviated. In addition, the diagnosis of non-small cell carcinoma was made by joint fluid cytology. A biopsy was also taken from the right lung tumor, and as the histological diagnosis was similar to that of the joint fluid, chemotherapy was started. CT after the start of treatment showed a decrease in the right shoulder joint fluid and no progression of right scapular metastases. Conclusion: In case of malignant joint fluid associated with bone metastases, a severe prognosis is expected, but arthrocentesis and irradiation can reduce pain.