Epileptogenesis factors with regard to oxidative stress and theophylline administration.

Kawakami Y.

Department of Pediatrics, Nippon Medical School Tama Nagayama Hospital.

Role of b7-h1 in immune privilege of the eye.

Hori J.

Department of Ophthalmology, Nippon Medical School.

Serum biomarker of lung carcinogenesis induced by cigarette smoking.

Okano T, Gemma A, Kudoh S.

Department of Internal Medicine (Divisions of Pulmonary Medicine, Infectious Diseases, and Oncology), Nippon Medical School.

Usefulness of multidetector-row computed tomography in the planning and postoperative assessment of perforator flaps.

Ono S, Hyakusoku H, Ogawa R, Oki K, Hayashi H, Kumita S.

Department of Plastic and Reconstructive Surgery, Nippon Medical School.

Significance of Angiogenesis in the Intra-alveolar Fibrosis in Interstitial Pneumonia.

Takahashi M, Yamamoto M, Kunugi S, Ishizaki M, Fukuda Y.

Department of Analytic Human Pathology, Graduate school of Medicine, Nippon Medical School.

Special Training Course for Simulated Patients Who Participated in the Advanced OSCE at Nippon Medical School.

Aso R, Yoshimura A, Shimura T, Takayanagi K, Iino Y, Kobayashi Y, Seino Y, Hidaka H.

Academic Quality and Development Office, Nippon Medical School.

Resection of pancreatic metastasis from renal cell carcinoma and an early gastric cancer.

An 81-year-old woman, who had undergone left radical nephrectomy for renal cell carcinoma 17 years previously, was found to have a mass approximately 5cm in diameter in the body of the pancreas and an early gastric cancer. The patient was suspected of having pancreatic metastasis from renal cell carcinoma and an early gastric cancer and underwent distal pancreatectomy, splenectomy, and distal gastrectomy. Histologic examination showed that the pancreatic tumor was a clear cell renal cell carcinoma that had metastasized to the body of the pancreas and that the gastric cancer was a well-differentiated adenocarcinoma that had invaded the mucosa. Twenty months after the operation, the patient was well, without any evidence of recurrence. Renal cell carcinoma metastatic to the pancreas with gastric cancer rarely occurs, and surgical resection might have improved the quality of life in this patient. Careful long-term follow-up is necessary for patients who have undergone surgery for renal cell carcinoma.

Matsutani T, Sasajima K, Miyamoto M, Yokoyama T, Maruyama H, Yanagi K, Matsuda A, Kashiwabara M, Suzuki S, Tajiri T.

Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School.

Successful Management of Duodenal Varices by Balloon-occluded Retrograde Transvenous Obliteration.

We describe a case of duodenal varices successfully treated with balloon-occluded retrograde transvenous obliteration (BRTO) alone. A 63-year-old man presented with tarry stools. Computed tomography demonstrated dilated varices around the duodenum. Emergency endoscopic examination revealed varices of the second portion of the duodenum without active bleeding. There was no evidence of bleeding in the esophagus or stomach. Colonoscopy revealed no bleeding sites in the colon. On the day after admission, a superior mesenteric arteriogram obtained in the venous phase demonstrated a collateral vein from the inferior pancreaticoduodenal vein to the inferior vena cava. Retrograde venography performed via the right femoral vein confirmed that the right inferior adrenal vein was the draining vein and that the collateral vein was occluded. There were no tarry stools after BRTO. The patient was discharged 7 days after BRTO. Two months after discharge, computed tomography showed no dilated varices around the duodenum. Three months after discharge, endoscopy confirmed the absence of varices. No bleeding has been detected as of 10 months after discharge. We conclude that BRTO is an effective treatment for duodenal varices.

Hotta M, Yoshida H, Mamada Y, Taniai N, Bando K, Mizuguchi Y, Kakinuma D, Kanda T, Watanabe K, Tajiri T.

Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School.

A case of metagonimiasis complicated with multiple intracerebral hemorrhages and diabetes mellitus.

Metagonimiasis yokogawai is an unusual intestinal parasitic disease caused by metacercariae of Metagonimus yokogawai. The first clinical manifestations of this disease do not always correlate with gastrointestinal signs. A 61-year-old man with left hemiparesis and disorientation was admitted to our hospital because of atypical nonhypertensive multiple intracerebral hemorrhages, which were conservatively treated. The patient was discharged from our hospital after 2 months without any neurological deficits; however, he was readmitted owing to a body temperature higher than 38 degrees C for nearly 2 weeks. Examination of stool revealed eggs of M. yokogawai, and the body temperature returned to normal after administration of praziquantel. Furthermore, the control of the patient\’s diabetes mellitus (DM) markedly improved after the treatment, although the patient had had DM for more than 2 years. We conclude that DM is a chronic sign of metagonimiasis in carriers and that intracerebral hemorrhage might be an acute sign in the aggravated phase of the disease.

Yamada SM, Yamada S, Takada H, Hoshiai YC, Yamada S.

Department of Neurosurgery, Yamada Hospital.

Experience with direct kugel patch method for repair of adult inguinal hernia.

The direct Kugel Patch method is a minimally invasive but nonlaparoscopic preperitoneal method of hernia repair which has various ideal characteristics including all the benefits of laparoscopic hernia repair without the risks of complications. In this retrospective study, we report our experience with this method for adult inguinal hernia repair. Forty-four hernias, including 35 indirect, 7 direct inguinal hernias, and 1 recurrent indirect inguinal hernia, in 41 patients were surgically repaired using the direct Kugel patch method. The average operation time was 45.6 +/- 11.3 min, and the average hospitalization time was 6.2 +/- 5.0 days. There were 5 complications of seroma and only 1 recurrence of hernia which were successfully managed. We concluded that the direct Kugel patch method provides an ideal approach to adult inguinal hernia repair with short operation time and hospital stay and a very low risk of complications or recurrence.

Kurihara Y, Yamakawa T, Yoshino M, Ogata M, Watanabe M, Tokunaga A, Tajiri T.

Department of Surgery, Keihin General Hospital.