A 60-year-old female presented with occipital headache and limitation of neck movement. Neurological examination showed weakness of the right sternocleidomastoid muscle. Magnetic resonance imaging revealed a cystic lesion at the craniocervical junction and posterior compression of the brain stem. The lesion was totally removed through the transcondylar approach. The histological diagnosis was neu renteric cyst. The transcondylar approach provides a direct operative view of the clivus and anterior craniovertebral junction.
We report a patient with cystic lymphangiomas diagnosed by endoscopic ultrasonography and resected by partial polypectomy. A 42-year-old woman consulted a nearby physician because of a positive fecal occult blood test. Barium enema and colonoscopy revealed the presence of abnormalities. On March 11, 1997, she was admitted to our department for further evaluation and treatment. A barium enema examination revealed two protruding lesions in the transverse colon. Colonoscopy showed a teardrop-type mass in the left side of the transverse colon. The mass was cushion-sign positive, and its shape readily changed on respiration and with changes in body position. Another superficial smooth mass was found in the right side of the transverse colon. Ultrasonography of the colon confirmed the presence of a submucosal mass showing a cyst-like pattern. Cystic lymphangiomas were diagnosed and resected endoscopically. Histopathological examination revealed markedly dilated ducts consisting of a single layer of endothelial cells in the submucosa of the colon. The diagnosis was cystic lymphangioma.
Sir,We report on a case of mucinous adenocarcinoma arising from a fistula-in-ano, which formed a huge subcutaneous mass in the buttock.A 68-year-old diabetic man was referred to our hospital. Two years prior to the admission, the patient had first recognized a small subcutaneous nodule which gradually increased in size. On admission, he complained of a spontaneous pain. The mass measured 12×7 cm, and the covering skin had some ulcers with a foul smell.A contrast-enhanced transverse T1-weighted MR image (Fig. 1) revealed a huge cystic mass. The wall showed marked contrast uptake. Some enhancing solid components were also disclosed. The content showed homogenous low signal intensity on T1-weighted images, whereas a T2-weighted image (not shown) revealed marked hyperintensity.On another transverse image (Fig. 2), which was obtained at the cranial aspect of the lesion, a tubular structure was disclosed. This finding implied a fistula between the mass and the anus, although no direct continuity was identified.These MR findings in conjunction with the clinical course strongly sugEur Radiol (
The clinical features and biochemical basis of this Japanese patient with GM2 gangliosidosis AB variant were determined. Immunocytochemical analysis using cultured fibroblasts as samples is available for the diagnosis of this disease.
The authors investigated the protective effects of the urinary trypsin inhibitor urinastatin on acute renal failure induced in rats by gentamicin (240 mg/kg body weight i.p. for 3 days) and by mercuric chloride (3 mg/kg s.c.). In rats injected with gentamicin, glomerular filtration rate (GFR), renal plasma flow (RPF), and percent fractional sodium excretion (%FENa) were 151 ± 51 μl/min/100 g body weight, 0.69 ± 0.31 ml/min/100 g and 0.73 ± 0.32, respectively, whereas in rats given 100,000 U of urinastatin the renal function was significantly ameliorated (GFR 318 ± 43 μl/min/100 g RPF 1.41 ± 0.35 ml/min/100 g), although the %FENa (0.46 ± 0.26) was not significantly improved. A 50,000-unit dose of urinastatin prevented the deterioration of renal function to some extent following administration of gentamicin: GFR 219 ± 66 μl/min/100 g and RPF 0.93 ± 0.43 ml/min/100 g. In the study using mercuric chloride, treatment with 75,000 U of urinastatin protected the kidney from HgCl2 poisoning, yielding values of 294 ± 93 μl/min/100 g (GFR), 1.03 ± 0.41 ml/min/100 g (RPF), and 1.44 ± 0.72 μl/min/100 g (%FENa) as compared with respective values of 169 ± 48 μl/min/100 g, 0.7 ± 0.18 ml/min/100 g, and 2.22 ± 1.35 in the untreated rats. Renal histology revealed mild to moderate tubular epithelial changes in untreated rats, but preservation of an almost normal tubular structure in urinastatin-treated rats in both studies.
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