Medicine

We present three rheumatoid arthritis (RA) patients successfully treated with traditional herbal medicine (THM: Kampo). The treatment with THM resulted in a decrease in RA disease activity such as DAS28, as well as in the serum levels of anti-cyclic citrullinated peptide antibodies (anti-CCP) in 3 cases. These observations suggest that...

A 47-year-old woman demonstrated bilateral wrist joint pain during 4 weeks. Her status did not fulfill the ACR classification criteria for RA, and her symptoms had almost disappeared 4 weeks later. After about 1 year, she again complained of tenderness and swelling in the bilateral wrist joints. The laboratory data...

To assess some simple blood parameters at birth that can be used as a basis to suspect α-thalassemia minor (ATM), a prospective study involving 202 consecutive neonates with MCV of less than 95 fl or less were checked for Hb Barts by HPLC. The group was divided into two, one...

Background: Due to the rise in the number of reports of stress cardiomyopathy in the literature, awareness of this condition is increasing. Although different names have been used to describe this condition, the similarities in clinical, electrocardiographic, echocardiographic, and angiographic features suggest that they represent the same spectrum of diseases...

Aspirin and clopidogrel are the most commonly used antiplatelet agents in patients with coronary artery disease. The existence of resistance to these agents has been a controversial issue and new drugs are being developed to overcome this problem. Laboratory tests, which can identify resistance and correlate this with clinical outcome,...

Postoperative complications resulting from bariatric surgery can lead to severe vitamin-deficiency states. A patient who underwent bariatric bypass surgery and later developed Wernicke’s encephalopathy prompted us to present her interesting case history for discussion. Although bariatric surgery is known to be a risk factor for Wernicke’s encephalopathy, this diagnosis is...

Guillain-Barrè syndrome (GBS) is usually associated with symmetrical weakness, and therefore asymmetrical weakness may confuse diagnosis. We report on a patient with GBS subsequent to Campylobacter jejuni enteritis who had asymmetrical weakness with CNS involvement. The patient tested positive for anti-ganglioside antibodies, including anti-GM1 IgM, anti-GD1b IgG, and anti-GT1a IgG....

Background: Pulmonary arterial pressure (PAP) varies considerably in heart failure (HF) despite similar degrees of left ventricular (LV) dysfunction. Bradykinin alters vascular tone and common variations in the kinin B2 receptor (BDKRB2) gene exists. We hypothesized that genetic variation in this receptor would influence PAP in HF. Methods: 131...

Objectives: Hemoptysis is an alarming symptom of underlying lung disease. Clinicians are often unsure how to deal with and follow up patients who have had a single episode of hemoptysis, especially if the cause remains unknown despite thorough examination, because a second, more severe episode of hemoptysis might occur despite...

Objective: Presentation of pyoderma gangraenosum (PG) as an important differential diagnosis for wound healing disorders after cesarian section. Adequate therapeutic regimens are discussed. Case report: A 39-year-old woman developed a PG after cesarean section. A treatment with prednisolone and cyclosporine A was started. Within three days of treatment, the inflammatory process...

Rhytides, wrinkles and other signs of photoaging are gaining in prevalence due to increased sun exposure, phototoxic drugs and demographic changes. Cosmeceutical products, lasers, and surgery have all been used to reverse the signs of aging. However, these treatment modalities have suffered from either limited efficacy or a high incidence...

Introduction: Thyroid hemangioma is very rare, and only a few cases have previously been reported. We encountered a patient with thyroid hemangioma diagnosed after surgery. Case Report: A 71‑year‑old woman visited our hospital with a mass in the left thyroid region. A 5‑cm, elastic mass of the thyroid was palpable in...

Objectives: To investigate the role of insulin resistance (IR) and insulin plasma levels (IRI) in patients with chronic liver disease (CLD) and hepatocellular carcinoma (HCC). Methods: We recruited the following patients: 125 with HCC, 128 with liver cirrhosis (LC) and 133 with chronic hepatitis C (CHC). IR was assessed by the...

Some epidemiological evidence shows a link between abnormality of lipid profiles and variations in serum calcium. However, it is unknown whether this association resulted from confounding factors. The present study was designed to investigate the relationship between serum lipids and calcium. Serum calcium was corrected for albumin. Major confounding factors...

Metastatic tumors to the liver resulting in fulminant hepatic failure are a rare occurrence and have not been previously described in patients with gastrointestinal stromal tumor (GIST). A 70 year-old man was referred to hospital with postprandial discomfort. On examination a 19.5 cm large epithelioid GIST of the stomach was...

Endoscopic papillectomy is a promising and challenging endoscopic intervention. The aim of this study was i) to classify the differential indication, and ii) to study the outcome in papillectomy of suspicious tumor lesions of the papilla of Vater (papilla). Methods: Thirty nine patients were enrolled (22 males/17 females; range of age,...

Dementia is a syndrome characterized by a decline in cognitive function. Alzheimer’s disease and cerebro-vascular disease are the most common causes of dementia. Many factors (genetic, life style, vascular etc.) appear to play some role in the development of dementia. Statins significantly reduce vascular disease and could reduce cognitive impairment...

The term ‘frailty’ has often been used—by clinicians and researchers alike—to characterize the most vulnerable and weak amongst the elderly. The treatment and care of this subgroup of older individuals presents the most challenge to clinicians and other health care professionals. Although there is no clear consensus on the issue...

Background: The author intended to clarify the therapeutic effect and prognostic factors of metastasectomy and timing of pulmonary metastases in osteosarcoma patents. Methods: Data was obtained retrospectively on all consecutive osteosarcoma patients from 1985 to 2005 in author’s institute. Fifty-two patients with pulmonary nodules were identified, including 24 patients undergoing pulmonary...

The well-written and researched article reported in Clinical Medicine: Oncology by Dr. Washio and Dr. Mori entitled “Risk factors for renal cell cancer in a Japanese population”1 makes evident the differences in incidence and mortality rates from renal cell carcinoma (RCC) between different populations and highlights the relevance of carrying...

Adenomatoid tumors are responsible for 30% of all paratesticular masses. These are usually asymptomatic, slow growing masses. They are benign tumors comprising of cords and tubules of cuboidal to columnar cells with vacuolated cytoplasm and fibrous stroma. They are considered to be of mesothelial origin supported by histochemical studies and...

Objective: To determine, by phenotypic and genotypic methods, oxacillin susceptibility in Staphylococcus aureus strains isolated from pediatric and neonatal intensive care unit patients seen at the University Hospital of the Botucatu School of Medicine. Methods: A total of 100 S. aureus strains isolated from the following materials were studied: 25...

Early colonization of the infant gastrointestinal tract is crucial for the overall health of the infant, and establishment and maintenance of non-pathogenic intestinal microbiota may reduce several neonatal inflammatory conditions. Much effort has therefore been devoted to manipulation of the composition of the microbiota through 1) the role of early...

Background and Methods: Anthroposophic treatment for anxiety disorders includes special artistic and physical therapies and special medications. We conducted a prospective cohort study of 64 consecutive adult outpatients starting anthroposophic treatment for anxiety disorders under routine conditions. Main outcomes were Anxiety Severity (physician and patient ratings 0–10), Self-rating Anxiety Scale...

Background: Bipolar disorder is a lifelong problem with imperfect available treatments. Recent research has shown potential benefit of nutritional treatment for mood symptoms. The goal of the current study was to determine whether adults with bipolar disorder reported treatment benefit from consuming a micronutrient formula. Methods: Self-report data were...

Background: Medical termination of pregnancy [TOP] during the early first trimester is commonly used. However, treatment failure which warrants surgical intervention occurs in small proportion of patients. Our objective was to examine the effectiveness and predictive value of sonographic measurement of endometrial thickness during a follow up visit after medical...

Over the recent years there has been a gradual rise in the use of pharmaceuticals during pregnancy. Knowledge on placental drug transfer and metabolism has increased during the past decades as well. Investigation of the transplacental transfer of any therapeutically useful drug is essential to the understanding of its metabolic...

The development of nelarabine as a therapeutic agent to treat various forms of hematologic malignancies spans more than 40 years. From the bench top to the bedside, basic scientists and clinical scientists in the pharmaceutical industry and academia collaborated with regulatory agencies to bring this drug to the market. Studies...

The renin-angiotensin system can be inhibited through inhibition of angiotensin I generation from angiotensinogen by direct renin inhibitors, inhibition of angiotensin II generation from angiotensin I by angiotensin-converting enzyme inhibitors and by direct inhibition of the action of angiotensin II receptor level. Aliskiren, the first direct renin inhibitor to reach...

Background: There is controversy about the appropriate treatment for severely displaced and unstable comminuted fracture of distal radius (type C of AO or OTA classification). Recently, there has been an increase in the number of predilection for surgical management of this fracture. Aim: To determine the radiographic outcome in type C...

Objective: To identify significant risk factors associated with repeat emergency department (ED). Visits for violent injuries in youth fi rearm victims. Methods: The study subjects of this retrospective cohort study were fi rearm victims aged 18 and younger presenting to a Pediatric Emergency Department/Trauma Center at Children’s Hospital of Wisconsin...

Modern medicine has brought us many miracle cures. In the 21st century, especially, we are blessed with increasingly powerful disease combating tools, such as functional genomics, proteomics and stem cells. Decades of medical and pharmaceutical research have produced thousands of medicines that allow us to treat and prevent diseases better...

Background: The Kt/V value demonstrates the dose of hemodialysis (HD). However, because of several existing methods for calculating delivered dialysis dose, Kt/V values can, in fact, be different for the same set of pre-/post-dialysis blood urea concentrations. Methods: In the study presented here, another formula was derived for calculating...

Inadequate patient handoffs have been an area of focus for patient safety improvement. Insufficient communication and risks or “shortcuts” taken by staff members during handoffs could negatively affect the safety of patients in a department of obstetrics and gynecology. Other factors that contribute to inadequate handoffs are the caregiver feeling...

Preeclampsia is a major cause of maternal mortality worldwide, with many preventive strategies tested. In this review we intend to provide a synthesis of available studies of these strategies that have been tested, including systematic reviews. We will not be performing systematic review of the studies here. Of these strategies...

Introductory Editorial by Dr David Simar, School of Medical Sciences, University of New South Wales, Sydney NSW 2052, Australia.

Background/Aims: We have previously isolated a novel lysosomal cysteine protease, cathepsin Y, which produces a kinin-potenciating octapeptide from rat plasma. The present study aimed to elucidate the influence of protein-restriction on cathepsin Y mRNA expression in tissues of growing rat. Methods: Weaning rats were fed either 20% casein (normal-protein, NP)...

Dietary acidity is a likely contributor to the development of osteoporosis. Dietary acidosis in an ovine model has effects on trabecular bone that have been previously shown to mimic human osteoporosis. Effects on cortical bone using this model have not been investigated. The objective of this study was to examine...

Introduction: It has been shown that in experienced hands repeated CABG is doable procedure. However the quality of life after third time CABG has not been evaluated so far. Patients and Methods: The peri-operative data of 25 (22 male, mean age of 65.5 ± 8.0 years) consecutive patients in a single...

Introductory Editorial by Dr Hendrick B. Barner, Clinical Professor, Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A.

Introductory Editorial by Dr Joshua Cameron, Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, U.S.A.

Mr. Smith is an 85-year-old nursing home patient who has suffered from dementia for the past eight years. He has been bed bound and uncommunicative for the last six months. He was admitted with aspiration pneumonia three times in the past year. Over the last few months he has lost...

The purpose of this article was to investigate the outcome measures developed and used in palliative care. The paper involved a literature review of published research. Many of the reviewed papers concluded similarly that there was lack of good quality evidence on which to base conclusions. More high quality evidence...