The Tohoku journal of experimental medicine
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Tohoku J. Exp. Med. · Sep 2006
Case ReportsChronic subdural hematoma coexisting with ligamentum flavum hematoma in the lumbar spine: a case report.
We present a case of a chronic spinal subdural hematoma combined with a ligamentum flavum hematoma in the lumbar spine treated surgically. An 83-year-old woman receiving antiplatelet medicine due to an angina suffered from pain in her lower extremity and gait disturbance after a backward fall. Radiological findings including magnetic resonance imaging (MRI) revealed hematoma in the ligamentum flavum at the level of L2 - L3 and a chronic subdural hematoma at the level from L3 to L5. ⋯ Her clinical symptoms completely disappeared after surgery. To the best of our knowledge, this is the first case of combination of chronic subdural hematoma and ligamentum flavum hematoma in the lumbar spine treated by surgery. Chronic spinal subdural hematoma and hematoma in the ligamentum flavum should be considered as a cause of progressive nerve root compression in patients with anticoagulant therapy, and an appropriate pre-operative diagnosis would be needed to achieve complete decompression of subdural and epidural hematoma.
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Tohoku J. Exp. Med. · Sep 2006
An off-seasonal amantadine-resistant H3N2 influenza outbreak in Japan.
An off-season community influenza outbreak with high prevalence of amantadine-resistant influenza A/H3N2 occurred during September-October 2005 in Nagasaki Prefecture, Japan, prior to standard influenza circulation. A total of 48 patients with influenza-like-illness (ILI) visited a clinic during the outbreak and 27 (69.2%) of 39 ILI patients were positive for influenza A with rapid antigen testing (Quick Vue Rapid SP Influ). Nine patients were not tested because their symptoms were compatible for influenza without examination. ⋯ The 4 nasopharyngeal samples were positive for influenza A M2 gene in polymerase chain reaction, and sequencing results all showed identical mutation at position 31, serine to asparagine (S31N) in the gene, conferring amantadine resistance. The phylogenetic tree analysis demonstrated that the hemagglutinin (HA) gene sequences of the 4 samples formed a distinct cluster (named clade N) from recent circulating H3N2 strains, characterized by dual mutations at position 193, serine to phenylalanine (S193F), and at position 225, asparatic acid to asparagine (D225N). Our findings suggested that an off-season community influenza outbreak in Nagasaki was caused by a distinct clade in H3N2 (named clade N), which possessed characteristics of amantadine resistance.
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Tohoku J. Exp. Med. · Aug 2006
Small cell undifferentiated carcinoma of the ascending colon with rapid enlargement after resection: report of a case and review of the literature.
Although adenocarcinoma represents the vast majority of neoplasms of the large intestine, small cell undifferentiated carcinoma (SCUC) also arises from the colorectum. SCUC of the colorectum is highly malignant and shares the similarities in histologic characteristics, behavior, and histochemistry with SCUC of the lung. We report herein a case of SCUC in the ascending colon with rapid enlargement after resection. ⋯ The tumor rapidly enlarged, and the patient died of multiple organ failure. SCUC is a tumor with a high malignant potential. Radical treatment cannot be achieved by surgical therapy alone and hence further studies of effective adjuvant therapy would be required.
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Tohoku J. Exp. Med. · Jul 2006
Comparative StudyPentoxifylline, a methyl xanthine derivative, reduces peritoneal adhesions and increases peritoneal fibrinolysis in rats.
Peritoneum has an intrinsic fibrinolytic activity that breaks the peritoneal adhesions. Peritoneal injuries with ischemia interfere this fibrinolytic activity and cause adhesions. Pentoxifylline, a methyl xanthine derivative, improves blood flow by decreasing its viscosity and also increases fibrinolytic activity in plasma. ⋯ PAI-1 levels were lower in animals receiving IP pentoxifylline compared to control animals and those treated with IV pentoxifylline (p = 0.048, p = 0.015, respectively). Peritoneal hydroxyproline levels were similar among the three groups. Our results suggest that pentoxifylline administration either through IV or IP may reduce peritoneal adhesion formation probably by altering peritoneal fibrinolytic activity.
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Tohoku J. Exp. Med. · Jun 2006
ReviewAirway remodeling in asthma and its influence on clinical pathophysiology.
Bronchial asthma has been characterized by chronic and allergic airway inflammation, which induces cytological and histological changes in the airway structure over time. These changes have been called airway remodeling, which includes goblet cell hyperplasia, subepithelial fibrosis, and hyperplasia and hypertrophy of airway smooth muscle cells. Airway epithelium in asthma is often occupied with goblet cells, which contain secretory granules. ⋯ Recent studies have demonstrated the molecular and cellular mechanisms of goblet cell hyperplasia, subepithelial fibrosis, and hyperplasia and hypertrophy of airway smooth muscle cells. Several lines of evidence suggest that airway remodeling has been induced by cytokines and mediators produced in chronic allergic airway inflammation. Thus, early intervention with inhaled corticosteroid may prevent progress of airway remodeling by suppressing allergic airway inflammation.