Nutritional status tends to be poor in patients undergoing chemotherapy. We investigated anorexia caused by olfactory dysfunction by examining olfactory sense in chemotherapy patients and healthy volunteers. We used the Open Essence® olfactometry test, which assesses the accuracy of identifying 12 different odors. Twenty-seven patients (mean age 69.8 years) who received chemotherapy for lung cancer from March 2016 to September 2017 participated in multiple olfactometry examinations from the start of their chemotherapy. We also examined 284 healthy volunteers (mean age 41.9 years), and performed an additional subgroup analysis with 35 volunteers aged 60 years or older (mean age 73.2 years) to more closely align with the mean age of the patients. The mean accuracy rate was 44.4% for the patients, although this rate varied from odor to odor. In contrast, the mean accuracy rate of the healthy volunteers was 76.8%. There were significant differences according to sex and smoking history. For the subgroup of healthy volunteers aged 60 years and older, the mean accuracy rate was 54.5%; accuracy rate decreased as age increased. There was no significant difference in the accuracy rate according to type of chemotherapy, but the overall rate for patients was lower than that for healthy volunteers. Our results show that olfactory sense in lung cancer patients undergoing chemotherapy is altered compared with that in healthy individuals. Smoking habit was shown to have the greatest effect and most of the lung cancer patients in this study were smokers. A change in olfactory sense caused by smoking was also noted in the healthy volunteer group. We intend to conduct a similar investigation of patients with diseases other than lung cancer in the future as well as utilize the findings to investigate nutritional status.

OBJECTIVE: Since there have been few large series studies to date, we investigated the relationship between Trousseau's syndrome associated with cerebral infarction and its clinical associations with ovarian cancer. METHODS: In this study, we investigated the association between cerebral infarction onset and ovarian cancer. Eight-hundred twenty-seven consecutive ovarian cancer patients from 4 affiliated academic institutions were included in the study over a 12 years period. All patients were histopathologically diagnosed as epithelial ovarian cancer and were analyzed retrospectively. RESULTS: The 27 patients (3.2%) presented with cerebral infarction during the study period, 14 patients onset prior to treatment (1.7%), and 13 patients onset after start of initial treatment (1.5%). Univariate analysis and multivariate analysis was performed for onset of Trousseau's syndrome and various clinical and pathological parameters. There was no statistical significance between the occurrence of Trousseau's syndrome with age or International Federation of Gynecology and Obstetrics (FIGO) stage; however, univariate analysis and multivariate analysis demonstrated a statistically significant association between clear cell carcinoma (CCC) and non-CCC histology. CONCLUSION: Thus, our results demonstrate that Trousseau's syndrome with cerebral infarction occurred with greater incidence among CCC cases compared to non-CCC cases.
Cerebral Infarction* ; Gynecology ; Humans ; Incidence ; Multivariate Analysis ; Obstetrics ; Ovarian Neoplasms* ; Retrospective Studies ; Thromboembolism

Aims: To verify the significance of medical and dental cooperation over the past 10 years in Haramachi Red Cross hospital, which does not have a dental department. We will also investigate the situation of inpatients' oral cavities in our hospital. From these results, we will discuss future activities about medical and dental cooperation.

Methods: We analyzed questionnaire and the field survey data related to medical and dental cooperation. We also compared the current oral assessments by a dentist and the past assessments without a dentist.

Results: A dental hygienist has participated in NST (Nutrition Support Team) rounds at our hospital since 2005. From then, we started oral assessments for inpatients and we recommend for patients to visit a dentist before surgery or chemotherapy. Furthermore, we have held oral care seminars for medical staff. As a result, medical staff have demonstrated an improvement in awareness and technique for oral care. Since 2013, a dentist from the Agatsumagun Dental Association has started oral assessments for preoperative inpatients at our hospital. However, we found that the frequency of problems in their oral cavities and that of postoperative pneumonia have not decreased.

Conclusion: Medical and dental cooperation is effective for our hospital. We think that it is important not only to promote medical and dental cooperation, but also to perform a dental checkup and educate the general population on periodontal disease.

BACKGROUND: Although organotin compounds are widely used as PVC stabilizers, catalysts and biocides, their effects on humans are not well known. However, their acute intoxication is known to cause neurotoxicity in the central nervous system, renal toxicity, and hepatotoxicity. As there has been no previously published case of organotin intoxication in Korea, we report here the first Korean case of acute exposure to organotin. CASE REPORT: A 43-year-old male with disorientation and behavioral change was admitted to a hospital. He had been working as a tank cleaner for several different companies in the previous 8 years and a week before admission, he had cleaned a tank containing dimethyltin (DMT) for 4 days. A day after finishing the job, he suffered decreased memory, behavioral change and progressive mental deterioration when he arrived at the emergency room. The result of spinal tapping was negative but on the 4th day of admission he deteriorated into a state of coma along with metabolic acidosis and severe hypokalemia. High levels of DMT and trimethyltin (TMT) were detected in a highly sensitive urine analysis. After conservative treatment and chelation therapy, the patient showed some clinical improvement but the neurological defects persisted. CONCLUSION: The patient appeared to have been intoxicated from the acute exposure to a high level of organotin while cleaning the tank.
Acidosis ; Adult ; Central Nervous System ; Chelation Therapy ; Coma ; Disinfectants ; Emergency Service, Hospital ; Humans ; Hypokalemia ; Korea ; Male ; Memory ; Organotin Compounds ; Poisoning* ; Spinal Puncture

The purpose of this study was to investigate characteristics of past injuries of female university soccer players in comparison with injuries in male university soccer players.
We investigated past injuries of female players (n=32) and male players (n=24) . A past injury was defined as any injury sustained during soccer that required admission to a team doctor, medical attention or absence from practices or games for more than seven days.
The most frequent injury was Joint Injuries in both female and male players. High occurrence of overuse injuries of lower leg was most apparent in the female players. The 32 female players had experienced 144 injuries, or 4.5 injuries per player, and the 24 male players had suffered 85 injuries, or 3.5 injuries per player. The numbers of injuries per player of female players were 1.3 times higher than the male players. Also, the incidence of injury was 0.64 (injury/player/year) in female players, and 0.27 (injury/player/year) in male players. The incidence of injury of female players was significantly larger than that of male players.
We conclude that the prevention and care of overuse injuries in lower leg is very important for female succor players.

A 41-year-old woman was given a diagnosis of Behçet's disease at age 25. When she was 31, a large aortic pseudoaneurysm developed near the left renal artery. Isolation of the aneurysm and anatomical grafting and ancillary bypass were performed. Ten years later, a graft duodenal fistula developed. Extra-anatomical reconstruction was done after complete resection of the original graft and the infectious lesion. It was found that the intra-abdominal organs were receiving blood supply only from the inferiol mesenteric artery. Moreover, severe ischemia of the intra-abdominal organs was a concern during surgery. Therefore, hepatic vein oxygen saturation was monitored continuously with a Swan-Ganz catheter for ischemia of the intra-abdominal organs. It proved to be a very effective indicator and we could perform this operation safely. Reoperation of grafting is often inevitable in patients with Behçet's disease. Also, two stumps of abdominal aorta were left in this patient because of the extra-anatomical reconstruction. Pseudoaneurysm may later occur at the site of the stumps, thus necessitating careful follow-up observations.

Intravenous leiomyomatosis (IVL) is defined as the extension into the venous channels of histologically benign smooth muscle tumors originating either from a uterine myoma or from the walls of a uterine vessel. We report a case of IVL extending to the right atrium and right ventricle through the right internal iliac vein and the inferior vena cava. The patient was a 43-year-old woman. The tumor was extirpated by simultaneous median sternotomy and laparotomy with the use of cardiopulmonary bypass. It was necessary to use cardiopulmonary bypass in order to open the right atrium. However, it proved difficult to insert the venous cannulae into the inferior vena cava due to the presence of the tumors. In order to perform the cannulation, a trans-right atrial excision of this tumor was necessary. Nevertheless, hemodynamic deterioration tended to occur during the procedure because of unexpected bleeding. We believe that to safely carry out this operation, it would be better to ensure circulatory arrest before trans-right atrial excision of the tumor. We have been continuing preventive antiestrogen therapy because recurrence would be very likely if any tumorous tissue remained after surgery. Fortunately, no intravenous infiltration of the tumor has been detected by either pelvic computed tomography or ultrasonography during the 26-month follow-up period. Surgical excision of the tumors and postoperative medication are now believed to have been effective.

A 52-year-old man was referred to our institution because of a solitary aneurysm of the left common iliac artery. The presence of the aneurysm was demonstrated by CT and angiography. The aneurysm had a diameter of about 30mm. The walls of the bilateral external iliac arteries were irregular, like a string of beads. The aneurysm was resected and replaced with a vascular prosthesis. Histological examination of the aneurysm and a part of the left external iliac artery indicated a diagnosis compatible with fibromuscular dysplasia (FMD: medial fibroplasia). A solitary iliac aneurysm is rare, and is usually due to atherosclerosis. However, the aneurysm in this case was related to FMD. To the best of our knowledge, only one other case of a solitary common iliac aneurysm caused by FMD has so far been described.

A 30-year-old male with manic-depressive psychosis took in 30ml of undiluted Smithion to commit suicide. Ten hours or so later, he was found in state of subconsciousness and admitted into our hospital.
1. From the initial trance, he fell into a twilight state. After suffering from an amnestic syndrome and encountering difficulties in concentrating his attention, he was found in a depressive state on the 18th day. This depressive state was presumably a recurrence of the depression with which he had once suffered and therefore proved different from the depressive state unique to organophosphate poisoning.
2. In respect to the psychatric symptoms caused by acute and subacute organophosphate poisoning and its sequela, a study is made on the basis of literature to make some comment.
3. After a clinical course of two-and-a-half years, it was found that there were a slight degree of disturbance to registration and a drop in mental capacity. These were considered sequelas. These symptoms would not hamper his everyday life, but there were signs of a rise in the sense of quilty conscience and misery when he was in a depressive state.
4. EEG indicates that the waves were slowing and paroxismal or sporadic small spikes. Two years later, EEG-findings were slightly abnormal with many sporadic slow α waves. No abnormalities were observed in computerized tomogram.