Internal medicine
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Pancreatic neuroendocrine neoplasms occasionally have a cystic component. We herein report a case of multiple hepatic tumors, including a huge one and a 24-mm sized pancreatic cystic lesion. The hepatic tumor showed an enhancement pattern consistent with hepatic adenoma. ⋯ Surgical resection was performed. After the surgery, somatostatin receptor scintigraphy detected an occult lumbar spine metastasis. Huge multiple liver and bone metastases of the neuroendocrine neoplasm G2 component were seen, with a G1 small primary lesion.
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Case Reports
Fulminant Hepatitis due to de novo Hepatitis B after Cord Blood Transplantation Rescued by Medical Treatment.
A 53-year-old man presented with fulminant hepatitis due to de novo hepatitis B. He had been diagnosed previously with adult T-cell leukemia (ATL) and previously resolved hepatitis B virus infection. ⋯ The aggressive medical protocol included entecavir, prednisolone, plasma exchange, hemodialysis, and bilirubin adsorption. We herein report successful medical treatment for fulminant de novo hepatitis B in a patient considered unsuitable for liver transplantation.
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Recently, severe cases of infection due to hypermucoviscous Klebsiella pneumonia (hmKP) have been reported in Japan. The Amami Islands in Japan are also endemic regions for Strongyloides stercoralis. Disseminated strongyloidiasis strain often causes severe enterobacteria infection; however, whether or not chronic strongyloidiasis induces it remains unclear. ⋯ He died on the seventh hospital day. Strongyloides stercoralis were only found around the polyp in the cecum. Chronic strongyloidiasis can also induce severe infection due to enterobacteria, especially hypervirulent pathogens like hmKP, through the induction of mucosal rupture.
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There have been a few reports on the administration of rituximab for relapsing-remitting multiple sclerosis (RRMS) in the acute phase. We report the case of a 62-year-old woman with an acute lesion of RRMS. ⋯ We believe that the B cells were promptly depleted after the infusion of rituximab, and that the inflammatory reactions related to the B cells were suppressed. We suggest that the administration of rituximab can be considered as a treatment option for acute-phase RRMS when conventional therapies are not effective.
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Objective To examine the degree of metabolic abnormalities and their association with the sociodemographic background or mental illness/cognitive disability among homeless men in Nagoya, Japan. Methods We interviewed 106 homeless men (aged 54.2±12.7 years) and measured their metabolic parameters. Mental illness and cognitive disability were diagnosed using the Mini-International Neuropsychiatric Interview and Wechsler Adult Intelligence Scale-III test, respectively. ⋯ Conclusion Stressful conditions while living on the streets may exacerbate hypertension and liver dysfunction, and unhealthy food habits when living in a temporary residence may exacerbate low HDL levels. In addition, an inability to self-manage due to cognitive disability may increase the ALT, TG, and BMI values. The provision of homeless people with the skills to sustain independent living conditions and ensure a healthy diet is required.