Follicular dendritic cell sarcoma (FDCS) is a very rare malignant tumor derived from follicular dendritic cells. Radical resection is the standard therapy for patients with local disease, but an optimal chemotherapy regimen has not been determined for unresectable disease. We report our experience of an FDCS patient with multiorgan involvement. In the present case, disease was only located in the pancreas initially and radical resection was performed. Multiple metastasis developed after the treatment and several factors that indicated a poor prognosis were observed. The present case had a very poor prognostic disease but survived for a long time with a good performance status because of the multiple chemotherapy regimens, which follow therapeutic strategies for malignant lymphoma and soft tissue sarcoma. As far as we know, this is the first study reporting the indication of bendamustine for FDCS patients.
[Purpose] The efficacy of diffusion tensor imaging in the prediction of motor outcomes
and activities of daily living function remains unclear. We evaluated the most appropriate
diffusion tensor parameters and methodology to determine whether the region of interest-
or tractography-based method was more useful for predicting motor outcomes and activities
of daily living function in stroke patients. [Subjects and Methods] Diffusion tensor
imaging data within 10 days after stroke onset were collected and analyzed for 25
patients. The corticospinal tract was analyzed. Fractional anisotropy, number of fibers,
and apparent diffusion coefficient were used as diffusion tensor parameters. Motor
outcomes and activities of daily living function were evaluated on the same day as
diffusion tensor imaging and at 1 month post-onset. [Results] The fractional anisotropy
value of the affected corticospinal tract significantly correlated with the motor outcome
and activities of daily living function within 10 days post-onset and at 1 month
post-onset. Tthere were no significant correlations between other diffusion tensor
parameters and motor outcomes or activities of daily living function. [Conclusion] The
fractional anisotropy value of the affected corticospinal tract obtained using the
tractography-based method was useful for predicting motor outcomes and activities of daily
living function in stroke patients.
Delirium and the need for family and decision-making support were underrecognized by hospital staff. PCT intervention for CRF and depression was often withheld because of very late referral. Appropriate timing of PCT consultations is important. Providing educational opportunities for hospital staff to comprehensively assess patient's multidimensional distress is needed.
Carnitine deficiency is reportedly associated with increased pain sensation in diabetes mellitus and fibromyalgia, but the association between serum carnitine concentration and cancer pain has not been fully elucidated. We investigated the incidence of carnitine deficiency in patients with cancer pain, and examined the effect of the patients' demographic and clinical characteristics on pain intensity and carnitine deficiency. The serum carnitine concentration was measured in 50 patients with cancer pain receiving non-steroidal anti-inflammatory drugs, but not opioids. Multivariate regression analysis was used to determine the association of carnitine concentration, pain intensity, age and gender with hemoglobin and C-reactive protein (CRP) concentrations. Carnitine deficiency was detected in 9 of the patients (18.0%) and found to be significantly correlated with an elevated CRP concentration (P=0.039). In conclusion, although there does not appear to be an association between carnitine deficiency and cancer pain, it may be affected by inflammation or infection.
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