Internal medicine
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We herein report a rare case of cutaneous and lymph node metastases that recurred 12 years after radical total gastrectomy for stage IIA gastric cancer. A 62-year-old man had undergone total gastrectomy for stage IIA gastric cancer 12 years earlier without postoperative adjuvant chemotherapy. ⋯ The lymph node specimens and cutaneous biopsies indicated late recurrence of the gastric cancer. Concurrent chemoradiotherapy was administered effectively, but after eight months, the patient died due to deterioration in his general condition.
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A 48-year-old man presented with a sustained fever. Abdominal computed tomography revealed multilocular liver abscesses. He underwent percutaneous needle aspiration, yielding straw-colored pus. ⋯ Liver abscess caused by A. aphrophilus is extremely rare. We herein report the first such case in Japan. Even fastidious organisms, such as A. aphrophilus, should be correctly identified using mass spectrometry or 16S rRNA gene sequencing for adequate treatment.
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Objective There is no report on the risk stratification of major cardiac events (MCEs) with a combination of the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score and ischemic reduction detected with rest 201Tl and stress 99mTc-tetrofosmin myocardial perfusion single-photon-emission computed tomography (SPECT) after revascularization in Japanese patients with coronary artery disease (CAD). Methods This was a retrospective study. The patients were followed up to confirm their prognosis for at least one year. ⋯ A receiver operating characteristic analysis indicated that the best cut-off values of the residual SYNTAX score and ΔSDS% were 12 and 5%, respectively, for the prediction of MCEs. The patients with a low residual SYNTAX score (<12) and high ΔSDS% (≥5%) had the best prognosis, while those with a high residual SYNTAX score (≥12) and low ΔSDS% (<5%) had the worst prognosis. Conclusion The combination of the residual SYNTAX score and ischemic reduction detected with nuclear cardiology is useful for predicting MCEs after revascularization.