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Kasukabe, Japan

Aso H.,Kasukabe Municipal Hospital | Aso H.,Nihon University | Kamura Y.,Nihon University | Hanazaki H.,Nihon University | And 3 more authors.
Japanese Journal of Clinical Ophthalmology | Year: 2016

Purpose: To report neuroretinitis in a female working at a veterinary hospital. Case: A 38-year-old female presented with visual field defect in the left eye since one week before. The left eye showed optic disc swelling and serous retinal detachment involving the macula. The left eye showed macular star leading to the diagnosis of neuroretinitis 10 days later. She was found to be working at a veterinary hospital. Her forearm showed papules and scratched wound. Antibody studies showed elevated levels of IgM and IgG antibodies to Bartonella henselae, confirming the diagnosis of cat scratch disease. Conclusion: The present case illustrates that a veterinary hospital worker may be prone to neuroretinitis as manifestation of Bartonella henselae infection secondary to cat scratch disease.

Fukushima M.,Kasukabe Municipal Hospital | Fukushima M.,Nihon University | Katagiri A.,Nihon University | Mori T.,Nihon University | And 2 more authors.
Neurological Surgery | Year: 2010

It has occasionally been reported that mechanical trauma and posttraumatic inflammation may promote metastasis from a primary tumor to the site of the trauma. However, the etiologies that contribute to the metastasis formation at the trauma site remain unknown. We describe here the first case of skull metastasis from hepatocellular carcinoma (HCC) revealing a growing subcutaneous mass at the site of skull fracture. A 58-year-old man had undergone surgical resection of a primary tumor in the liver 2 years previously and was in clinical remission. The patient fell head first off his bicycle and suffered a skull fracture in the squamous portion of the left temporal bone without ostelysis. Three months after the head trauma, he presented at our department with a growing lump on the left side of his head, and magnetic resonance (MR) imaging revealed an osteolytic tumor extending into the adjacent subcutaneous and epidural space. The tumor was at the same location as the skull fracture sustained in the bicycle accident. The mass lesion was radically resected with surrounding normal bone. The tumor formed a well-demarcated mass with osteolysis of the inner and outer skull tables, and the inner layer of the dura mater was intact. The histological diagnosis for the surgical specimen from the skull tumor was a HCC identical to the primary tumor. Immunohistochemically, the tumor cells were diffusely and strongly positive for vascular endothelial growth factor (VEGB and basic fibrous growth factor (bFGF). It is well known that the extracellular matrix and cytokines are involved in the processes of not only bone healing but also metastasis formation. The present case suggests that several processes involved in bone healing modified the microenvironment and represent a possible cause of skull metastasis from primary tumor.

Tokumaru A.,Kasukabe Municipal Hospital | Tsutsumi T.,Dokkyo Medical University
Equilibrium Research | Year: 2010

The effect on the vestibulo-ocular reflex (VOR) is evaluated by using a caloric stimulation in which the ears of subjects in the supine position are irrigated with water or air. Studies on the clinical application of caloric stimulation have shown that the stimulation results in a gentle rise of VOR response, which does not precisely reveal the time course of VOR onset. In our study, 14 healthy subjects were evaluated with a step stimulus technique, which showed the onset and offset of caloric stimulation with a rapid change of the position of the subject's head during continuous irrigation of his or her ear. The technique showed a rapid rise (indicating an activation) and consequent gentle attenuation (indicating a compensation) of VOR response. On-step (from sitting to supine position) and off-step (the opposing maneuver) stimulation delivered the same characteristics of this rise and attenuation with opposing direction, through the ampulo-petal and ampulo-fugal convection along their lateral semi-circular canals respectively. Repeated ipsi-lateral stimulation with an interval of 4 minutes caused an increased adaptation of VOR during the on-step response. Some possible reasons for these results might be the occurrence of a central adaptation of VOR or a mechanism involving the peripheral vestibular apparatus such as depletion of the synaptic transmitting substance. Step stimulus of one side did not demonstrate any contribution to subsequent contra-lateral stimulation with the same 4-minute interval. This finding supports the idea that the peripheral vestibular system contributes to the adaptation of VOR. Introducing this step stimulus technique into the clinical examination setting would facilitate the elucidation of the pathophysiological basis of vestibular deficits.

Kimura S.,Kasukabe Municipal Hospital | Kimura S.,Nihon University | Kotani A.,Kasukabe Municipal Hospital | Takimoto T.,Kasukabe Municipal Hospital | Katayama Y.,Nihon University
Neurological Surgery | Year: 2011

We encountered a case of multiple metastatic brain tumors with simultaneous multiple cerebral hemorrhages. A 45-year-old male suffered from sudden left hemiplegia and was admitted to our hospital. CT scans on admission revealed multiple cerebral hemorrhages with surrounding brain edema in the right frontal lobe, left frontal lobe, right occipital lobe and right basal ganglia. On full-body examination, renal cell carcinoma of the left kidney and multiple metastatic tumors in the lung, liver and vertebral body were identified. We continued conservative therapy, but the patient's condition worsened and he died 36 days later. The autopsy findings indicated that all hemorrhages had occurred in the necrotic tissue associated with the metastatic brain tumors. Simultaneous multiple cerebral hemorrhages caused by metastatic brain tumors are very rare, and the differential diagnosis of cerebral hemorrhage due to metastatic brain tumor and hypertensive cerebral hemorrhage is difficult. The present case indicates that metastatic brain tumor should be taken into consideration in cases with simultaneous multiple intracerebral hemorrhages.

Kurita D.,Nihon University | Hatta Y.,Nihon University | Hojo A.,Nihon University | Kura Y.,Kasukabe Municipal Hospital | And 3 more authors.
Cancer Genetics | Year: 2016

The Philadelphia chromosome (Ph) is the most frequent chromosomal abnormality detected in adult acute lymphoblastic leukemia (ALL). This chromosome forms the BCR/ABL1 fusion gene; thus, ABL1 exon a2 is generally used as a primer-binding region for the detection of the fusion transcript via reverse transcription polymerase chain reaction (RT-PCR). We observed a rare case of adult Ph-positive (Ph+) ALL, in which the BCR/ABL1 fusion transcript was not detected using the ABL1 exon a2 region primer. However, we were able to isolate a PCR product by RT-PCR with the BCR exon 13 (b2) and ABL1 exon a3 primers. Analysis of the sequence of the RT-PCR product revealed that the fusion point was between BCR exon 14 (b3) and ABL1 exon a3, and that the transcript lacked ABL1 exon a2. The patient achieved cytogenetic remission through combination chemotherapies, but relapse occurred before hematopoietic stem cell transplantation and the patient died 11 months after the initialization of chemotherapies. If the BCR/ABL1 fusion transcript is undetected with the ABL1 exon a2 region primer in Ph+ ALL cases, an RT-PCR analysis that can detect the b3a3 type BCR/ABL1 fusion transcript should be considered to improve diagnosis. © 2015 Elsevier Inc.

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